man who weighed more than four hundred pound yet notwithstanding this man appeared in publick and to tel you the whol truth in this Person Nature began to assay some certain kind of evacuation of the serous or wheyie humor by the Navel And the very same hath been found to happen unto others also in whom the Body hath attained unto so immense a bigness that they could neither move nor yet so much as breathe freely But now in such like Persons as these there is not an equal augmentation of all the parts of the Body as it is in them who grow and are naturally enlarged but only of their Flesh and of their Fat there is an excessive and over-great encrease The Causes The conjunct Cause therefore of this Tumor of the whole Body is the Flesh and the Fat. And here truly one while the Flesh and otherwhile the Fat is augmented and sometimes they are both alike encreased But the Antecedent Cause is the over-great abundance of Fat and good Blood And for this cause it is that this Tumor is referred unto Tumors proceeding from the Blood And yet notwithstanding the Reason of these is far differing from that of other Tumors arising from the Blood For the conteining Cause of bloody Tumors is the Blood but the conteining Cause of this Tumor is the Fat and Flesh and the antecedent Cause is the Blood The rest of the bloody Tumors that are properly so called spring from the Blood issuing out of the Veins or Vessels into some other places which never hapeneth in this extream and extraordinary corpulency in the which Blood is never known to fall or issue forth into other places but it is evermore put unto the Body But now what the Causes may be that much Flesh and Fat should be generated will easily and soon be discovered if we wel consider the Causes of breeding Flesh and Fat Now then Flesh is abundantly bred in those whom we call Eusarcoi that is Persons of a pure untainted and sound Flesh yet alwaies provided that the material cause of Flesh to wit nourishing Food be not wanting and likewise that the native virtue generating Flesh be as it ought to be vigorous and active That which administers matter towards the breeding of flesh is great abundance of good blood the which to produce and generate meats of a good and plentiful juyce and also a due and right temper of the Liver to wit hot and moist are evermore requisite But now again that much Flesh may be bred from much Blood it is required that there be a sound and healthful habit of Body and a good temperament of the musculous parts in the Body which said temperament is likewise hot and moist Hereunto also as we are to understand very much conduceth an easie or idle kind of life in the which there is not much Blood wasâ—ed as also the suppression of their accustomed bleedings and evacuations of Blood especially in Women As touching the original and increment of Fat many and various are the Opinions and controversies among the Physitians at this very day the which for me in this place to examin were altogether impertinent And therefore in a word we say that Fat is generated from the Oyly and fattish part of the Blood falling from out of the Veins and Arteries into the membranous parts and there digested by the innate virtue and temperate heat of the Membranes That great store of Fat should be bred in the first place the Liver is a principal cause thereof For if by reason of its excellent and perfect temperament it doth not generate either much earthy and cold nor much cholerick and hot juyce but produce a sweet fat and oyly Blood and fil the Veins and Arteries therewith and if this Blood be not consumed or wasted in the habit of the Body but that it stil continue to be more cool and moist then this Blood is there converted into Fat Ease likewise and the intermission of Exercise the retention of accustomed evacuations aliment temperately hot and moist and generally all things which either outwardly or inwardly any waies conduce to the making up of a plentifull and temperate mass of Blood or that have in them an efficacy in qualifying and allaying the over-intense heat of the Blood of the Entrails and of the habit of the Body Hence it is that Galen hath left it upon record that all Bodies tending towards a cold and moist temperament become Fat. And with this of Galen agreeth what Prosper Alpinus in his Book of the Egyptian Physitians Chap. 9. hath written his words are these The Bodies of the Egyptians saith he are hot and dry in regard that they live under the hottest and withall dry position of the Heavens but because they moderate and lessen this heat and driness by their dayly drinking of water by their continual use of meats that have in them a cooling virtue and likewise by their frequent use of Baths which they make for themselves with sweet Water their bodies hereupon become extraordinarily fat to fat that he never beheld in any part of the world in so great a number and generally such extream fat and gross Persons as he saw at Grand Cayre in Egypt For he reports that very many of them are so exceeding gross and corpulent and generally so fat in their Breasts that they have Paps of a far larger size and thicker than the greatest that ever he had observed in any Woman Other things there are which demonstrate unto us the truth of this assertion to wit that a hot temperament of the Liver makes very much for the breeding and augmenting of fat For I my self knew a Person of Honor who after he had been sick and was recovered of a malignant Feaver grew to be so extreamly fat and gross that he could very hardly move or stir himself in any place where he fat and as for the bulk of his body he came never a whit behind him whom we have formerly mentioned Signs Diagnostick As concerning Corpulency therefore it is sufficiently obvious to every mans Eye But then whether or no it only produce some kind of deformity and be no more then a Symptom or else whether it be not to be accounted a Disease or preternatural affect the hurt and offended actions wil evidence unto us of which we wil now speak Prognosticks 1. What the inconveniencies and discommodities are that this over-great fleshiness or as we term it extream Corpulency carries along with it I shal give you an account thereof in the words of Avicen that expert Arabian Physitian For thus he in his fourth Book Part 7. Tract 4. Chap. 5. Superfluous fat saith he is that which hinders the body from and in its motion walking and operation and streightning the Veins with an undue and dangerous constriction whereupon it oppilates and stops up the passages of the Spirit so that hereby it is many times extinguished and for the same reason likewise it is
provoked and stirred up both for the repairing of the clour and the pouring in of blood And to tel you the truth in what place soever there is such an effusion of Blood it may in general be called Ecchymosis yet notwithstanding Paulus Aegineta in his fourth Book Chap. 30 according to the diversity of the parts affected reckoneth up three kinds or species all which may be called by their several distinct and peculiar names The first is those which we call Hypopia and by Hippocrates named Hypophthalmia that is Subocularia to wit palenesses or wannesses under the Eyes Now it is termed Hypopion from Ops that is the Eye because it appeareth under the Eyes and it is an Affect differing from that we call Hypopyon the difference lying in this that the former is written by ω and ι the latter by ο and Ï… from Pus which the Greeks call Pyon because it is a collection of Pus or purulent matter under the Cornea Tunicle The second Species is Hyposphagma which some in special term Suggillatio to wit an effusion of blood into the Adnata or Cornea both of them Tunicles of the Eye touching which we have already spoken in the first Book of our Practice Part 1. Sect. 2. Chap. 32. The third Species is that which is caused by the Contusion or bruising of the Nails this Species Hippocrates calleth Hyponychos and the Latine Authors term it Subungulus in regard that it is an Affect under the Nails Contusion Somtimes with Ecchymosis there is likewise conjoyned a Contusion yea and somtimes also there is so great an abundance of Blood poured forth that it being collected under the Skin and the Muscles it there causeth a certain hollowness and lifteth up the part into a Tumor or Swelling There is also somtimes according to the Nature of the part conjoyned therewith a pain from whence it happeneth that more blood floweth thereto and by this means an Inflammation yea and sometimes likewise at the length a Gangrene is excited There is to bâ—â—â— a notable History of this in Johannes Philippus Ingrassias in his Jatropologia When in the yeer 1537. in an Hippomachie or Tilting as we call it the Marquess of Terra Nova ran with the Baron of Volaterran it so chanced that the armed Knee of the Marquess by reason of the Fury and extraordinary fierceness of their Horses gave so great a blow upon the bare and unarmed Leg of the Baron that the Contusion or bruise that followed thereupon was so great and grievous that the Baron died thereof four daies after By reason of this his so sudden and unexpected death the Physitians were question'd and called to an account for that they had not rightly and as was fitting managed the Cure In whose behalf and defence Johannes Philippus Ingrassias wrote those two Books of Apology under the name and Title of Jatropologia There is likewise extant in Gulielmus Fabricius Cent. 2. Observat 83. another History which you may there see shewing how dangerous Contusions may be The Signs Suffusions and these Suggillations are easily known For the very colour it self and the Swelling if at least there be any fal under the sense and are apparently to be seen The Causes are known by those things that went before and such as are likewise present For if any external Cause went before as a Blow a Fall and the like the Physitian may understand it from the relation of the Patient But if none of these shall happen we are then to consider the Blood in the Body and well to weigh by what means it becometh thus peccant and offensive Prognosticks 1. Although in truth these Ecchymomata are for the most part void of all danger and the blood that is yet thin may easily be dispersed yet if this be not done and that the blood be deteined any thing long in the part affected out of its own Vessels it then may prove to be of dangerous Consequence in regard that by this means there may be excited both a Corruption of that very part that is affected and likewise a damage and detriment unto the whol Body For the Blood being clotted together unless it be forthwith insensibly discussed or turned into Pus which is necessarily done where the Flesh is withall greatly bruised so that hence the part yet continueth soft it putrefieth and corrupteth and breedeth a Gangrene and very frequently bringeth Death and Destruction upon the sick Person 2. But there is great danger threatned and nigh at hand when the part affected continueth not any longer green or wan but inflamed and becometh very red hard and distended Of which we related that former notable History out of Ingrassias The Cure As for what therefore concerneth the Cure we wil first of all treat of the Cure of that Ecchymoma that followeth upon a Contusion For even this also very often happeneth and whoever he be that knoweth the Cure of this he shal have a sufficient store of Medicaments with which he may cure the rest since that the discussing Medicaments that are here to be drunk have their place likewise in the other First of al therefore if the contusion be great we must use the best of our â—kil and care to prevent and hinder the afflux of blood unto the place lest that thereby an Inflammation should be excited This is to be done by Venesection for which cause Galen commands That in a fal from on high and in beatings and bruisings a vein be opened and that although the blood doth not greatly abound yet that by opening a Vein it be drawn forth lest that an Inflammation should be excited from whence not only evil symptoms but oftentimes also even death it self hath its original And the truth is this Venesection is forthwith to be ordained and put in practise withal at the same time Defensives and Repellers are likewise to be placed neer about the part that may impede and prevent the influx of blood into the part affected such as are made up of Bole-armenick Terra sigillata or Sealed Earth of Lemnos Dragons blood Roses Myrtles the Nuts of the Cypress Tree Galls Pomegranate flowers Roots of the lesser Consound and the like As for instance Take Bole armenick Terra sigillat of each an ounce and half Chalk half an ounce let them boyl in Vinegar after they be boyled Take Pouder of red Roses the pure sine flour of the Root Consolida or Consound of each half an ounce and with the Oyl of Myrtles make a Cataplasm Or only which is likewise in common use the white of an Egg shaken together with Rose water and with burds or the courser part of flax applied unto the place affected Or Take the white of four Eggs the Oyl of Myrtle and Roses of each one ounce Bole armenick Dragons blood of each half an ounce Cypress Nut two drams a little Vinegar Mingle them c. And this is also here to be taken notice of that there be not many
an extream troublesome palpitation and beating of his Heart For the removal of this great Distemper there were many Remedies prescribed and administred not only by my self but likewise by the most expert Physitians of our Vniversity there All which when they could not in the least prevail over this contumacious and head-strong Disease by reason of the Patients continuing and persevering in his accustomed ill course of Diet he grew the worse thereby and after some few months were passed in the which by the advice of the Physitians he took no Physick at all for they were willing to commit unto Nature a part of the Cure of this Chronical Affect he began to complain of that part that lieth under his left Shoulder-blade The place of his grief being lookt upon and throughly considered there appeared unto me a notable Tumor soft unto the touch and attended with a beating and when pressed down with the Fingers it was then seemingly wholly hid and non-apparent but these were no sooner taken off but forthwith it returneth as before In short the Disease having gotten deep rooting being now become incurable our Patient within a very short time after departed this life But now that we might get the truth and certainty both of the nature and constitution of this Disease as also of the Cause thereof we dissected that part that was affected with the Tumor out of which there issued forth great store of Blood unsavory and stinking as it was all which Blood being wholly evacuated and throughly cleansed there appeared the prime and principle Artery under the Heart having its original from the great Vein in its ascending up into the Head exceedingly dilated and extreamly torn This Vein descending downward creepeth along through the Region of the Intercostal Muscles the Blood that flowed forth of it being heaped up in the spaces of the Muscles and in tract of time putrefying and corrupting had so vitiated and marred the Vertebra and Rib of that place that it seemed unto us altogether rotten and putrefied And therefore say we some other way and means of the generating of this Tumor is to be sought and found out The Author of the Book of the Medicin Definitions defineth Aneurysma by the relaxation of an Artery And so likewise Fernelius in the seventh Book of his Patholog and Chap. 3. asserteth that Aneurysma is a dilatation of an Artery ful of spiritful blood but all this while they do not express the manner how this is done Neither is it ever a whit credible that Aneurisma is caused by the dilating of both the Tunicles of the Artery but only by the widening of one of them For the Atteries have indeed a double Membrane one external which is slender thin and soft having of straight Fibres very many but of oblique ones very few and of transverse ones none at all the other internal which is close thick and hard having transverse Fibres but wanting straight and oblique ones And therefore if the Internal Tunicle be either broken by extension as easily it may be in regard of its hardness or else if it be opened by Section it doth not easily Cement and close together again because it is hard but now the external Tunicle in regard of its softness doth easily and soon grow together again and because it is so soft and wanteth both oblique and transverse Fibres it is thereupon extended by the Blood and the vital Spirit seeking their passage forth in an imperious and violent manner and so this kind of Tumor cometh to be excited in the which the force and the impetuous violence of the blood and the vital spirit may be discovered by the very touch Neither is that which Platerus objecteth of any weight or moment to wiâ— when he tels us that upon the alone bare Section that he saw made in the skin that covered over the Tumor the blood forthwith at first hid it self but then instantly sprang forth amain and this oftentimes saith he is in so great abundance that it cannot by any one use he what means he wil be any more stanched but that it issueth forth in greater abundance insomuch that the whol stock of Blood being almost spent it hath oftentimes brought a sudden Death upon the sick Person But indeed if we should determine that the Aneurisma proceedeth from the dilatation of these Tunicles of the Artery this Objection would then carry some weight along with it But in regard that according to the truth of the matter we have already asserted and determined that an Aneurysma ariseth from the dilatation of the exterior Tunicle alone of the Artery the internal being opened either by Section or by Rupture we cannot therefore by any means grant that the Arterial blood lieth hid under the whole Skin but because the external Tunicle is extraordinarily extended it cohereth and sticketh so close unto the Skin that it is extended together with it and is in a manner so become one therewith that it is almost impossible to cut the Skin without cutting the external Tunicle of the Artery And so then the result of al that hath been said wil be this to wit The nighest cause of Aneurisma That the proxime and nighest cause of Aneurysma is the opening of the interior Tunicle of the Artery and the dilatation of the external Now it is very frequently opened by Section when unexpert Chirurgeons instead of a Vein open an Artery or when at least together with the Vein they cut through the Artery that lieth under it Now if this at any time happen the external Tunicle in regard of its softness and neer alliance with the Tunicles of the Veins very easily and soon closeth together again but the interior by reason of its hardness remaineth open from whence through the patent and open place the Blood and vital Spirit endeavoreth to break forth and by this means distendeth the external Tunicle and causeth this kind of Tumor The same may likewise happen if the internal Tunicle of the Artery be broken either by the violent and impetuous motion of the Arterial blood or by any violent external cause and the overgreat distension of the Artery the external Tunicle that is more apt for extension being al this while safe and sound But now Whether or no that pulsation of the Arteries of which Platerus maketh mention in his Tract touching the palpitation of the Heart and touching which out of Fernelius and Ludovicus Mercatus we have already treated in the fourth Book of our Practice Part 2. Sect. 3. Chap. 9. may or ought properly to be referred unto Aneurysma I very much doubt For whenas the Membrane of either Artery is then whol and entire it seemeth rather to be an Affect in the Veins of kin to the swoln and distorted Veins that we cal Varices than this Tumor Aneurysma of which we are now treating Signs Diagnostick The Aneurysma is easily known and discerned from Ecchymosis because that in Aneurysma the color
threds or else the Tumor being opened about the midst of it after the emptying forth of what is therein contained we cut off the skin that being left remaining that was tied about and then a long spleen-like Plaister wel moistened in Wine and Oyl being laid thereon we conclude and perfect the Cure by Liniments But who is he that seeth not that this kind of Cure is not only cruel and so cruel that few or none wil submit unto it but that it hath likewise much danger in it and yet for al that doth not heal the sick person For although the Artery be bound about yet notwithstanding after the threds are loosened there is cause to fear lest that either an Haemorrhage follow or else that a new Aneurysma be caused And therefore the more secure and safe course is only to bind hard and press together the Tumor with Bands and Medicaments that so it may not gain any further augmentation Chap. 44. Of the swoln Veins caled Varices VArix with the Greeks Kirsos this being the name given unto it by the Greek Physians only for we find Aristotle in the third Book of his History of living Creatures Chap. 11. and 19. and Plutarch in the Life of Caius calling it Ixia as Galen in his tenth Book of the Method of Physick and last Chap. defineth it and as out of him Paulus Aegineta hath transcribed it in his sixth Book Chap. 82. and Aetius Tetrab 4. Serm. 2. Chap. 48 is the dilatation of a Vein this said dilatation of a Vein being called Varix as that before mentioned dilatation of an Artery was termed by the Greek Physitians Aneurysma of which in the foregoing Chapter But now these Varices happen in divers parts of the body but most frequently in the Thighs and yet notwithstanding somtimes likewise in the Temples as Paulus telleth us in the place before alleadged and somtimes in the lowest part of the Belly under the Navel and oftentimes also about the Testicles and the Cods which said Tumor is in special called Kirsocele The Causes They are generated from great store of Melancholly blood which as Galen writeth in his Book of black Choler Chap. 4. Nature oftentimes transmitteth unto those Veins that are in the Thighs by the which being distended and dilated they are rendred Varicose or swoln up and the skin that toucheth upon these kind of Veins in process of time becometh of a blackish color But now as for such in whom there is only great store of blood flowing in that is not Melancholy it resting indeed and wholly relying upon those Veins which there in that place are naturally more weak than elswhere doth dilate them but scarcely even dye them of such a like color as it happeneth when Melancholy blood shal produce these Varices For such are in very great danger if any one assay to cut forth the Veins affected of being surprised with Melancholly For this is frequently seen to happen not only in Varices but even in the Haemorrhoids also that consist of the same kind of humor even as the coming of them upon those that are mad is wont to be a freeing and discharging of them from their madness as Hippocrat in the sixth of his Aphorisms Aphor. 21. And yet notwithstanding scarcely ever doth good blood though it abound never so much by its great plenty alone produce and cause Varices as it doth if it be both plentiful and withall if it be thick which by its weight tendeth downward unto the Thight Whereupon it is also that the Varices have not their being until the ripeness of age as Hippocrates in Coac praenot toward the end teacheth us in regard that a thick and melancholly blood is not generated sooner in the Body And likewise Pliny in his eleventh Book and Chap. 45. writeth that the Varices happen in the Thighs of Men only and very rarely in Women Such likewise as are bald in these the Varices become not great but for such as while their baldness is upon them are afflicted with these Varices these come again to receive their Hair Hippocrat in the sixth of his Aphorisms Aphor. 34. Which yet notwithstanding Galen asserteth to be a falshood in his Comment unless haply any one wil understand this of that affect that Physitians call Madarosis that is the shedding or falling off of the Hair For this Affect since that it hath its original from vitious humors as likewise the Alopecia hath and also that we call Ophiasis if those very depraved humors being translated into the Thighs do cause the Varices the sick Persons may then possibly recover and receive their Hair again For if at the first the loss of the Hair proceeded from vitious humors their corrupting and corroding the very roots of the Hair then questionless these said humors taking now their course into some other place the Hairs will again return unto their naturall State The more remote Causes all those that make for then generating and breeding of thick and melancholly blood and especially the Spleen when it is distempered maketh much unto and helpeth forward the generation of these Varices And that likewise which much furthereth the flowing of the aforesaid humors unto this part may be comprised under on of these Heads to wit either a blow or streining overmuch long and tedious foot journeys extream hard labor and the like Signs Diagostick These Varices are easily known whenas swelling Veins is the very superficies of the Members and especially of the Thighs appear unto the very sight it self and the part affected appeareth either Leaden coloured or black and the Tumor being pressed down seemingly retreateth back but forthwith returneth again Prognosticks 1. These Varices of themselves carry little or no danger in them neither bring they any unto the Party thus affected but they rather preserve and free such as have them from other Diseases especially Melancholly Diseases touching which Hippoc. in the sixth of his Aphorisms Aphor. 21. thus writeth If Varices or the Haemorrhoids happen unto such as are mad they are thereby freed of their madness and the whole Body is by them throughly purged from all flatulent Blood 2. But if they be unseasonably taken away as Galen in his Book of Venesection against Erisistratus and Chap. 6. and in his Book of black Choler and Chap. 4. teacheth us Madness the Pleurisie the pain of the Reins the Haemorrhoid Flux the Cough and spitting of Blood the Apoplexy Cachexy Dropsie and other Diseases arise 3. Sometimes these Varices do pass into the Elephantia of the Arabians touching which we shal speak further in the next following Chapter The Cure Unless therefore the Varices be of the biggest size and that the Veins and the Skin by reason of their extension be so extenuated that there be great cause to fear a Rupture a profusion of blood and Death it self and again unless they be inflamed and extreamly painful or that there be present some great and
that they contract these Clefts especially about the Joynts yet nevertheless this same happeneth somtimes likewise unto the Feet It may be Cured most speedily and most conveniently by this Unguent Take Litharge of Silver Myrrh and Ginger of ech alike parts bruise and pouder them very small and so with Virgins Wax Honey and common Oyl as much as wil suffice make an Vnguent unto which for the rendering it the more grateful to the smel Musk and Ambar may be added THE FIFTH BOOK THE FOURTH PART Of WOVNDS Chap. 1. Of the Nature Causes and Differences of a Wound AMong the external preternatural Affects of the Body and such as are obvious unto the senses there remain Wounds Fractures and disjoyntings of which we will now speak in order And First of all as touching a Wound that it is a solution of Unity in a part Bone and softer Cartilage is without al doubt and controversie But yet nevertheless it is sometimes taken largely and somtimes in a more strict sence Celsus taketh it in the largest sence of all whn in his fifth B. and sixth Chap. he thus writeth That Wound saith he is far worse and more dangerous which it caused only by a Bruise then that which is made by incisiom and dividing the part so that it is also far better to be wounded by a sharp and keen edged Weapon then by that that is blunt It is taken in a large acceptation when it is attributed unto all kind of solution of Unity made by any sharp instrument whether this solution be made by pricking or by cutting like as Galen in his Sixth B. of the Meth. of Physick the first and following Chap. calleth the pricking of the Nerves the wounding of them It is taken strictly when it is distinguished from a pricking that a wound is the solution of Unity in a soft part made by a Cut from any keen and cutting instrument but a pricking is that solution of unity that is caused in a soft part by a prick from an instrument that is cutting By which it appeareth that the solution of Continuity in a soft part is wider and broader then a Wound whether it be made by cutting or by pricking For Unity may also be dissolved in a soft part by a thing that is not sharp but only hard and heavy and this may be the Skin either appearing whole or even broken likewise which happeneth in those Wounds that are inflicted by Bullets from Guns Moreover also the Unity of the soft part may be dissolved by extension which in special in the similary parts is called Rupture but in the Compound Apospasma to wit when those fibrous Ligaments and Threads by which the parts are fastned together the one to the other being broken the parts themselves likewise become broken A Wound what it is By all which it appeareth that a Wound is the solution of Unity in a soft part caused by a cutting and sharp instrument But if as Guido in the Second B. of his Chirurgery and Fernelius in the seventh B of his Meth. of Physick Chap sixth rightly admonish us the Wound become sordid and foul and that some thing be by the Pus or filthy corroding matter eaten away from the substance of the wounded part then the Wound passeth into an Ulcer or certainly we may very well say that an Ulcer is conjoyned with the said Wound The truth indeed is that Rudius in his B. of Wounds and first Chap. doth impugn this Opinion but al to little purpose For neither is it absurd as he without Reason thinketh that one Disease should be changed into another or that one should be added and Joyned to another The Wound and Ulcer they are both of them the solution of Unity in the soft part buâ— the Wound is made by section of cutting alone whereas the Ulcer is caused within it by Erosion and therefore it is that in an Ulcer there is somwhat that is lost from the substance of the part If therefore in a Wound of any part somthing shall be Eaten away and consumed from the substance of the flesh it is then altogether to be granted that now there is likewise present even an Ulcer also Which nevertheless is not so to be taken as though so soon as ever on the fourth day the Pus or filthy corrupt matter doth begin to appear in the Wound that then likewise an Ulcer may be said to be present For that said Pus proceedeth from the blood that is shed forth without the Veins or some Aliment that sticketh in the Capillary Veins and spaces of the parts neither is there then any thing Eaten away from the substance of the part But if there be so great an abundance of the Pus gathered together whatsoever the Cause thereof be that somthing be Eaten away from the substance of the part then it cannot be denied but that there is an Ulcer likewise present seeing that there are then present all things that are required unto the Essence of an Ulcer and in this Case the Cure is no longer to be ordered as in a single and simple Wound but as in an Ulcer But since that a Wound is to be accounted in the number of Diseases there may be enquiry made and that upon good grounds what actions they are that are hurt thereby Unto which it may be rightly answered that all the Actions of the said part and the severall uses thereof unto which the part is destined are hurt by the Wound whether that part perform those actions either as a similary or as an instrumental part That the Organical Actions may oftentimes be hurt by a Wound to wit when the part destined for motion is Wounded cannot be denied â—t being a thing so manifest since that the wounded Member can no longer be moved in a due and right manner As likewise the Vein that is cut assunder can no longer convey the blood unto the part for the nourishment thereof neither a dissected Artery the vital blood and spirits or a Nerve the Animal Spirits But indeed the truth is that the temperament of the part is not next of all and immediatly hurt by the Wound but yet never the less it is mediatly hurt to wit when the Vessels being cut assunder and the blood poured forth the heat of the part is withal dissipated and the influx of the Blood spirits and heat flowing in this last being so necessary and requisite unto the temperament of the part is altogether hindred For all which Causes the attraction of the part the Concoction the Nutrition and the expulsion is hurt And from hence it happeneth that the temperament being changed there are more Excrements generated in that part then otherwise were wont to be And from thence also it proceedeth that the Pus is not presently generated in the very beginning of the Wound but afterward to wit about the fourth day when the heat of the part that was dissipated is again restored The Use is
that out of it store of Blood be poured forth unto the Heart overwhelming it and suffocating the heat thereof Thirdly Al the internal wounds of the greater Vessels that cannot by any art be closed upon regard they cause the Blood being plentifully poured forth either out of the Veins or the Arteries that the spirits be suddenly dissipated therefore of necessity they speedily suffocate the wounded person Fourthly All those Wounds are said to be Mortal that suddenly take away the Respiration and hinder the ventilation of the Heart so that the Native heat of the Heart is suffocated and so cause that the Man die even almost in the very same manner as Apoplectical persons are wont to die And such like wounds are especially the Wounds of the Brain but yet not all of them since that there are many Wounds of the Brain that are not Mortal as afterwards we shall shew you and as we have already told you in the first B. of our Practice first part and 23. Chapter But those great Wounds and such as are the Cause that the Animal spirits be suddenly dissipated or that the blood being poured forth of the Vessels the Orifice of the Nerves be quite stopped and so by this means the influx of the Animal Spirits be hindered or that from the same an inflammation of the Brain or a feaver be excited And this is not only done by the Wounds of the very Brain it self but likewise by the strokes and vehement Confusions of the Head by which the Vessels of the Brain and those neer about it are broken and the Blood poured forth of them unto the beginning of the Nerves and there subsisting hinder the influx of the Animal Spirits And this may also happen if the Sinus or hollow places of the Brain chance to be hurt so that out of them blood be poured forth unto the Basis of the Brain and so it is likewise in the Wounds of the Eyes if they penetrate so deep that they open either the Vessels of the Brain or those that are in the Basis thereof or those that are neer about the said Basis of the Brain and so that the Blood poured forth unto the Basis of the Brain hinder the influx of the Animal spirits by compressing the beginning of the Neryes For although that the Blood if it be poured forth above upon the Brain may possibly be emptied forth by perforating and opening of the Cranium or Skul yet nevertheless if it be poured forth unto the Basis of the Brain it is impossible that it should ever be evacuated There seemeth yet nevertheless to be another way whereby the Blood poured forth into the Brain or about the Brain bringeth Death within a vâ—ry few daies if it cannot be evacuated For when as it is without the Vessels it beginneth to putrefie usually about the fifth day from whence feavers deliries and Convulsions are excited so that the man dieth in the same manner almost as one in a Phrensie That which is done by the Wounds of the brain the very same happeneth likewise from the spinal Marrow if it be indeed wholly cut assunder in the superior part thereof for then the motion of all the inferior parts and so of the Thorax likewise is abolished and the wounded persons are suffocated And unto one of these four waies I conceive that al kinds of Mortal Wounds may be referred And therefore if a Wound penetrate into any interior part of the Body so that thereupon the wounded person die within a short space of time we are then to Judg that that Wound was Mortal and if diligent inquiry be made I am of Opinion that it may be referred unto some one kind or other of these Mortal Wounds whether that Wound hurt the vital faculty it self immediatly or else hurt it by the intervening of some other Disease or Symptom For as Nicolaus Boetius writeth out of Felinus in his 323. Decision Numb 10. it is all one whether a Wounded man die of his Wound or of some infirmity caused by the same Which yet nevertheless is so to be understood if the Wound necessarily attract that Disease or that Symptom which is the Cause of Death But as for all the other Wounds whatsoever that cannot be referred unto some one of these manners I conceive that they cannot simply nor necessarily be accounted Mortal The which that it may be made the more plainly to appear we have it now in our purpose in special to weigh and discover unto you the Wounds of all parts that are to be accounted Mortal Now Hippocrates Judgeth the wounds of seven parts to be Mortal What Wounds accounted Mortal by Hippocrates whilest in his sixth Sect. Aphor. 18. he thus writeth Whosoever hath his Bladder out through or his Brain or his Heart or his Midriff or any of his smal Guts or his Stomack or his Liver that Wound is Mortal Which Aphorism notwithstanding in his Coaca or his Tract of Playsters Aphor. 509. he both Limiteth and Amplifieth when he thus saith From a Wound even Death it self may almost happen if any one be wounded in his Brain or in his spinal Marow or in his Liver or in his Midriff or in his Heart or in his Bladder or in any one of the greater Veins Death likewise soon followeth if any extraordinary great Blows be inflicted upon an Artery and upon the Lungs so that the Lungs being wounded the Breath that passeth out at the Mouth is less then that which issueth forth at the Wound But they suddenly perish whosoever they are that have received a Wound in the interior Nerves whether smal or g eat if the Blow or Wound be both Transverse and great but if the Wound be but smal and straight there are some that escape the danger But there is neither Death nor any great dangâ—r impending from those Wounds that are inflicted on those parts of the Body in the which there are none of these or which are as far distant at may be from these Indeed he limits the Aphorism whilest that he doth not simply write that such like wounds are altogether Mortal but almost and for the most part He amplifyeth it whilest that he addeth the spinal Marrow the greater and thicker Veins the rough Artery and the Lungs and the interior Nerves And therfore we wil in order consider the wounds of these parts For it is without doubt that the Wounds of the rest of the Parts are not at all of theâ—selves Morâ—al and this Hippocrates himself teacheth us in the above mentioned Aphorism 509. in Coacis Celsus in his 5. B. and 26. Chap. thus rendereth the foresaid Opinion of Hippocrates He cannot possibly be preserved that hath the Basis of his Brain his Heart his Stomack the parts of his Liver the Marrow in his Back-bone wounded or that person that hath either the middle of his Lungs or the Jejunum i. e. the hungry Gout or any of the smaller Guts or the Stomack or the Reins be
altered and at length the overgreat abundance of the blood is to be lessened and the vitious humors to be evacuated and this may fitly be done either by vene-section or else by purgation And therefore if blood abound in the body Venesection or blood letting so that therebe cause to fear the afflux there of unto the wound it is in this case unless it hath already before much flown forth very fit to open a vein and let forth a due quantity thereof Touching which Celsus in his fifth Book and 16. Chap. saith thus The Physitian ought to take forth some of the blood thereby to cause a dryness And presently he adds let the blood therefore flow forth more abundantly that so there may be the more abundant dryness but if it flow not forth sufficiently let the vein be opened as much as may be if it be so that the patient hath strength enough to bear this loss of blood And this is chiefly to be done in great wounds in which there is cause to fear an Afflux of the blood by reason of the pain of the Wounded part and here in this case blood is likewise to be drawn forth albeit that it doth not over-greatly abound in the body whereupon Hippocrates in his Book of the Joynts in the bruising and wounding of a Rib prescribeth the taking forth of blood out of the Arm where Galen in his Comment upon the place addeth Although saith he there be no extraordinary store of blood abounding in the body yet in those kind of blows and bruises we must have recourse unto vene section and letting out a due quantity of blood And in his second Book or the composition of Medicaments according to the places he commendeth in the first and chiefest place venesection for all pains of the head proceeding from a blow But now that this venesection may perform the whol work and that it may cause not only evacuation but likewise revulsion the vein is therefore to be opened a good distance from the part affected and on the contrary side as else where we have told you touching revulsion Now this is to be done with al speed possibly even the very first day of the wound and indeed before there be any medicament administred that so the afflux of the blood unto the wounded part may be prevented As for the quantity of the blood to be let forth it ought to be according to the store that is in the body and according likewise to the strength of the Patient and his ability to bear it And therefore if there flowed forth much blood before then venesection is to be omitted But if there flowed forth little or no blood before then you may now let forth a due proportion thereof but alwaies according to the strength of the Patient and no otherwise which you may best of al know by the Age of the wounded person the habit of his body the time of the yeer and other Circumstances touching which we have already spoken in its proper place But now if vitious humors abound in the body then there wil be need of purging Purging For it being so that the Wound is so much the more succesfully and more speedily cured by how much the more sound the part is and of a good constitution and that the ill constitution of the wounded part doth much hinder the cure we are therefore by all means possible to do our indeavor that so the vitious humors may not flow unto the part affected And thereupon seeing that by occasion of the Wound it may very easily come to pass that they may flow unto the part affected if they be found in the body they are forthwith to be evacuated And this is to be done in great wounds and where we have cause to fear lest that by reason of pain the depraved humors should rush unto the wounded part as also in those wounds where there is any kind of cutting or dilating to be used and where any bones is to be made bare of its flesh and in a word in al wounds whatsoever wherein the pain is more vehement then ordinary But smal Wounds and such likewise as are free from pain may be cured even without any purging but yet notwithstanding if the belly be bound it is then to be opened and loosened with a Clyster There are some indeed that are utterly against purgations in any wound whatsoever Whether those that are wounded may be purged as fearing lest that the humors being much stirred and disturbed by the sayd purgations should flow so much the more unto the wounded part But Hippocrates admitteth of them as we may see in his fourth Book of affections touching Fractures Text 48. Comment 3. and Galen in the fourth Book of his Method of curing Chapt. 4. and 6. And indeed reason it self perswadeth hereunto For if hot thin and cholerick humors abound in the body they render the blood very apt for motion and then by means of pain and want of rest they easily become hot and are inflamed and so afford an occasion for a feaver But now albeit that all the vitious humors abounding in the body are to be evacuated yet notwithstanding as we have sayd more especially the hot Cholerick and wheyish humors are to be evacuated which are more apt for motion and flowing and such as make much for the generating of inflammations and Erysipelases and such as do very easily excite feavers Even at the very first beginning a purgation is to be appointed to wit before ever there be any afflux excited and that any feaver shall happen But if there hath already happened any feaver purgation cannot then so conveniently and safly but indeed with some kind of danger be instituted and appointed And therefore to purge in Wounds there are most fitly and safely to be administred Manna Syrup of Roses Solutive Rheubarb the Leaves of Sene and of compositions Tryphera Persica Elect. de Psyllio Elect. of Roses of Mesues But we must abstain from the hottest purging medicaments lest that there should thereby be excited an afflux of humors that might dispose the wounded part unto an imflammation But in what manner the purgation is rightly to be ordered we have elsewhere already shewn you Chap. 14. Of the Wounds of the Veins and Arteries and of the stopping the Haemorrhage in Wounds AS touching the wounded parts themselves oftentimes by reason of them there is something that is peculiar to be done in the Curing of wounds How and after what manner the Cure of the wounds of private parts is to be rightly ordered we have already told you in those places which we shall afterward alleadg In the general the wounds of the Veins Arteries Nerves and Nervous parts do require a peculiar and proper kind of Cure The Haemorrage in Wounds And First of all indeed the Wounds of the Veins and the greater Arteries have this peculiar unto themselves to wit that there is alwaies some
notable Haemorrhage to accompany them which oftentimes causeth Faintings and Swoundings and other dangerous Symptoms But now the Blood floweth either out of the Veins or out of the Arteries and of these somtimes indeed out of the greater and sometimes out of the lesser and either out of one alone or else out of many And although that the wound inflicted upon the Vessel be the prime and principal Cause of the Haemorrhage yet it happeneth and that very often also that the blood may indeed now and then be stopt for a while and yet it may afterwards suddenly break forth again and this more especially chanceth upon the Commotion of the minde and provocation to anger And so likewise the presence of the Patients Adversary that gave him the wound maketh greatly for the causing of a new and fresh Haemorrhage in the Wound for which very Cause it is somtimes found by experience that the Blood that was before stanched and stopt begins again to flow forth a fresh And I my self remember that one Brother having wounded another and while the Wound was binding up the Brother that gave the Wound coming in to visit the other albeit that they were now reconciled the Blood suddenly brake forth afresh and this without doubt from the secret commotion of the minde for upon his departure and being forbidden to give any more visits the Blood again stanched Signs Diagnostick But now seeing that the Blood floweth either out of the Veins or else out of the Arteries that which floweth forth of the Veins is more thick more black and dark and less hot and it floweth forth without any great violence and rushing and with an equal pulse and doth far less deject the spirits all things else being answerable then that which cometh forth of the Arteries But now that that cometh out of the Arteries may rather be said to leap forth with violence then to flow and in the pouring out it is more hot and fervent more thin more yellow and more frothy and it is evermore accompanied with some notable change and alteration in the Pulse together with a weakness and dejection of the Patients strength If it be one of the greater Vessels that is opened then the Blood floweth forth in the greater abundance and with so much the greater violence but with far les if it be one of the less Vessels that is opened and wounded But now what Vein or Artery it is that is wounded and whether only one or more of them be wounded this must be known from those that are expert in Anatomy Prognosticks 1. An overgreat Haemorrhage in Wounds is very dangerous for the Blood is the Treasure of the Life and when the vital spirits are called forth it causeth a weakness of the Pulse it being so smal that it can hardly be discerned as also a frequency and inequality thereof and somtimes an intermission therein a fainting and swounding a Syncope an extream Coldness and Chilness of the outward parts and inordinate sweats a Convulsion sighings and sobbings Deliries and at length death it self And hence it is that Hippocrates in the 5. Sect. of his Aphorism Aphor. 3. saith that a Convulsion or Sighing happening upon an abundant flux of the Blood is alwaies very evil and dangerous And in the 7. Sect. Aphorism 9. that a Deliry or a Convulsion also happening from the abundant flowing forth of the Blood is evil and ful of danger And indeed it is so much the more dangerous if a Convulsion be joyned with a Deliry and that the Deliry happen not alone without the Convulsion 2. And this is more especially caused by the effusion of the Arterial Blood in regard that with it there is very much of the heat flowing in as also the vital Spirits that are most chiefly Necessary for the preservation of the life poured forth and dissipated 3. And moreover also for this reason the Wounds of the Arteries are more dangerous then the Wounds of the Veins because that they are more difficultly Cured and Consolidated by reason of their hardness their perpetual motion and the violent rushing forth of the Arterial Blood 4. And those Wounds of the Arteries are yet likewise far more dangerous and bring a long with them a greater Haemorrhage and such as is more difficult to Cure that are inflicted according to the length of the Artery or rransversly or obliquely then those in which the whole Artery is cut assunder as experience it self testifyeth so that indeed and as the Physitians are wont to perswade if the Haemorrhage cannot otherwise be stopt and stanched in regard that the whole Artery is not cut quite through it is then wholly to be cut assunder in a transverse manner For if that the Artery be thus transversly cut in twain it will again be contracted and its orifices will again close and shut and thereupon they wil the more easily meet and grow together again and the sooner be covered and shut up by the circumjacent flesh lying round about it neither will the Wound so gape and stand so wide while the Artery is dilated But if that the Artery be Cut long waies or obliquely or if it be wholly cut assunder any otherwise then transversly since that it is moved with the continual motion of the Dilatation and Contraction by this motion and especially the distention the Wound is more dilated and in every Diastole it gapeth whereupon the Blood is poured and leapeth forth with violence and rushing The Cure As in every over great Haemorrhage so likewise in this that proceedeth from a wound we meet with a twofold indication the one that which the wounded Vessels themselves suggest unto us which requireth a Union and Glutination The other that which the Haemorrhage suggesteth which if it be excessive and overgreat so that it dejecteth the strength and powers of the Body requireth that it be stanched even before ever that the Vessels be shut up and united For whereas unto the Union of the Vessels there is some space oftimes required so that the Patient may in the mean while run a great hazard of his Life the Blood is therefore immediately to be stanched That the Flux of the Blood therefore may be stopt although that the Wound of the Vessel be not as yet grown close together al those things are to be performed which may hinder and inhibite the motion thereof Now the Flux of Blood it impeded if with convenient Remedies and the binding up the orifice of the wound be closed and shut up In which manner if the Blood cannot be restrained and that it also break through the Wound closed and shut up in any manner whatsoever and all by reason of the impetuous violence of the Blood then all those things that do any waies help forward the violent motion of the Blood are to be removed such as are the overgreat abundance of the Blood stirring up and continually provoking the expulsive faculty Anger drinking of Wine hot and thin Humors
I may so say by their certain Spider-like interweavings and unto the which the very proper substance of the Vein doth adhere as growing thereunto But in other parts of the Body this flesh is of a far differing nature neither hath it as yet gotten any common name But that you may the better understand us now that we are treating of this subject I know nothing to the contrary but that you may term it a fleshy substance or truly at leastwise we may call it a certain flesh peculiar and proper unto this little part and of a differing Nature from that of the stomach from that of the Liver and likewise from that of the Arteries and Muscles in al which the flesh is not one and the same but as I said much differing Thus far Galen Wherefore that we may determine what the subject of an Inflammation is we affirm it to be any kind of fleshy substance which hath Veins Arteries which contain within them and convey blood the Cause of an Inflammation and are therefore even upon this account opposite to the bones which neither have nor are so much as capable of receiving Veins For in good truth flesh is the chief and principal subject of Inflammation yet notwithstanding the blood if it both diffuse it self into the adjacent parts and likewise draw those parts into a consent and agreement with it self they may then al of them both it they be truly said to be together inflamed of which Galen treats at large in his Book of Tumors Chap. 2. where he thus writes That al that flesh whose affection is now mainly and in the highest degree become an Inflammation should seem to be replenished with a flowing of the blood both the color and the Tumor it self demonstrate whereupon it appears all over humid and extreamly moistened like as is wool and a spunge That filth and putrid matter which flows forth whenas the Inflammation hath gotten a little door or gate as we may so tetm it to cast it out by gives a sufficient testimony unto the truth of what hath been said and I am rightly of Opinion that the skin it self is elevated and extended round about at once and together with the Tumors and swellings of those things that lie underneath it And in tract of time even the skin it self participates somwhat of the aforementioned flux insomuch that the Tunicles of the greater Vessels and also the very Membranes themselves may suffer together with the part inflamed and moreover also even the very Nerves and Tendons in process of time come to partake of this same Inflammation Notwithstanding now and then it chanceth that the parts abovesaid all or some of them if they happen to be wounded or any other way disaffected then the hurtful distemper I mean the Inflammation hath its original from out of those very parts But universally and generally there is not any thing that according to the bent of Nature perseveres to carry it self in al things exactly conformable unto the inflamed part if there be but any the least stop put thereunto but al things together with the flesh participate of the said flux so that oftentimes it reacheth even the very bones like as many times also iâ— is by them when they first of al are affected much promoted and furthered And in his sixâ—h Book of the Method of Physick Chap. 5. he thus writes Neither do I greatly wonder saith he if somthing resembling a Phlegmone shal in a smal proportion chance to accrue even to the bones themselves when broken The which likewise Avicen hath taught us in the 2. of his first Book Doct. 1. Chap. 5. where he acquaints us that Tumors happen unto the Members that are soft and yet notwithstanding that there is a time also when somthing happens unto the bones themselves which is assimilated into the matter of a Tumor or Swelling by the which said matter the Tumors magnitude is exceedingly heightned and its humidity greatly augmented And he adds the reason Neither is it saith he at al to be wondered at or ever a whit exâ—raordinary that that which receives an encrease or addition with nutriment should likewise receive it that is to say an addition with superfluity when either it penetrates into it or shal otherwise befal it as generated therein And in the species of Teeth Galen in his 5. Book of the Composition of Medicaments according to the parts affected Chap. 8. informs us That in the Teeth those things that are redundant and superfluous may excite and stir up in them a like resembling affection or rather passion such as is the Inflammation that appears in and neer about the fleshy parts Yea possible it is not only that the bones should get a thickness from the superfluous nourishment but likewise that another bone should be super-added unto them and grow up together with them Concerning the which Abenzoar in his 2. Theisir Tract 6. Chap. 1. hath these words And now and then saith he the bones are ingrossed and greatly augmented in their superficies either by the depraved corroding humors that are infused into the very bones or otherwise by the thick quittor and mattery filth which passeth over upon them from whence it is that they are hollowed corroded and augmented And again afterwards he wriâ—es more at large upon this subject in these words The bones saith he are somtimes greatned or to use his own word ingrossed beyond Natures intention by reason of an overplentiful and gross course of Diet it being likewise inordinate suddenly and rashly fallen upon and not as rather it should have been successively and by degrees advisedly entered into And long it is not since I heard my Father say that he on a time saw a certain man that had a bone super-added and bred in his back like unto the Harts Horn and that it was not altogether so hard as the natural bones and my Father himself saith he purged this man and emptied forth the gross humors that were in him and after he had so done he then puts upon the bone certain exsiccating or extream drying Medicaments insomuch that the said bone fel forth of the body like as the Hart casts his Horns and as other Beasts shed theirs in the Spring time And I my self also have had a Bone growing upon my Back which bred me extraordinary great pain and I thereupon by Purging freed my self of gross humors and laid upon the Bone Resolutives or Remedies of a dissolving faculty The Causes As for the Cause of this preternatural affect Galen writes that as it is altogether unknown unto the ignorant multitude of men so it is not very wel understood by all that profess themselves Physitians For although as I conceive it is agreed upon by al Physitians that Blood is the Cause of an Inflammation yet notwithstanding lest that as the same Galen writes in the place before alleadged we should seem only to declare our own single Opinion without
any further enquiry thereinto we wil therefore make the more accurate search after thereby to find out the Cause of an Inflammation in this manner following There would be no Tumor at any time generated in any part of the Body were it not that either its substance as it were boyling over with heat is poured out or that from without some new substance makes its approach For there are but two only causes to be assigned of the augmentation of the bulk and quantity in any thing whatsoever For either the radical moisture through an internal or external heat is resolved into an aery substance which as it is wel known requires a far greater space room for dilatation then formerly it had or else as we said before some new substance is extrinsecally from some other place superadded thereunto Now therefore of necessity it is that one of these two causes must be present when as in that hot and burning Tumor which we commonly call a Phlegmone the part is lifted up into a greater bulk than is ordinary or agreeable to the intention of Nature But now that the fervency and boyling up of the natural moisture or the effusion thereof is not the Cause appears by this because that every thing that is poured forth and converted as it were into spirits when it is cooled it assumes again its pristine quantity and as we may so express it puts off and laies aside the Tumor as by common experience it is most apparent But as for the parts inflamed let them be never so vehemently cooled yet wil they never return into the former state and condition nor ever cast off the Tumor or Swelling Furthermore if by reason of the effusion of the part and its conversion into spirits a Tumor should be caused in the part inflamed then necessarily upon the incision of the part the spirit should appear which yet as we see is nothing so but that rather there follows an effusion of Blood and the whole place by its colour and the looks thereof seems altogether full of Blood It remains therefore that the accession of some new substance is the cause of a Phlegmone But now that this new substance is the Blood appears from hence to wit that the Phlegmone is exceeding red both within and without Now this red colour is only proper unto and inseparable from the Blood Blood the nighest cause of an Inflammation for there is nothing that waxeth red in the Body beside the Blood and the Flesh which later notwithstanding viz. the Flesh cannot by any means be the cause of a Phlegmone For if the increment of the flesh were the cause of an Inflammation there would be indeed a Tumor or Swelling in the part yet so as notwithstanding the internal heat should remain sound and in an healthful plight without the least distemper and that also it should not in the least vary its pristine nature when as in no one thing that is augmented according to its substance the heat may properly be said to be heightned and encreased so far forth that the increment of the substance and quantity should any way differ from the change or alteration of the qualities But now the case is otherwise in a Phlegmone wherein the colour is changed and the heat grown to be more intense the said colour evidently demonstrating not only the quantity but likewise the quality of the substance Moreover that the Blood is cause of a Phlegmone may be manifestly evidenced by this that the place in the greatest Inflammations especially which now and then happen in Ulcers appears and seems all bloody round about which certainly would never be if blood were not the cause of the Inflammation Furthermore that Blood is Cause of the Inflammation that generating of the Inflammation which happeneth in Wounds doth evidently demonstrate For in new and fresh Wounds the Blood its true at the first flows forth but then afterward being compressed and kept in either by the hand or else with Ligatures or Medicaments that stop the issuing forth of blood or else lastly being suppressed and staid of its own accord it is then reteined either in the Orifice or Cavities of the dissected Vessels and there it is compacted and so wrought that it grows together like as clotted blood useth to do and there by a continued heaping up of the blood abundantly flowing thereunto it lifts up the part into a Tumor or Swelling and causeth an Inflammation An Inflammation what it is Since therefore the Conjunct Cause of an Inflammation is proved to be the Blood preternaturally flowing thereunto it is no hard matter thence to collect that an Inflammation is a preternatural Tumor of the fleshy parts as Galen in the place alleadged takes and understands the name of Flesh arising from the preternatural afflux of the blood and that therupon it must necessarily be hot red extended and accompanied with a kind of renitency or resisting property pain and pulsation or beating The manner how an Inflammation is bred But now that there may not be left to remain any the least obscurity about the nature of an Inflammation we will here add the manner also how a Phlegmone is generated and this we wil do out of Galen who in his Book touching the unequal Intemperies Chap. 3. hath in these words described it it is saith he a hot fluxion or flowing the which when it hath seized upon and seated it self in some muscelly part at first the greater Veins and Arteries are fil'd up and distended and next after them the lesser and so it is carried on untill that at length it arrives even at the least of them In these when the matter of the fluxion is forcibly impacted and cannot therein be any longer conteined it is then transmitted unto the outward parts partly through their own Orifices and partly by a percolation as it were and straining or sweating out of it through the Tunicles and then the void spaces which are betwixt the most principal parts are filled full with the fluxion And so all those parts or places are on all sides very much heated and overspread Those parts or Bodies are the Nerves Ligaments Membranes the Flesh it self and before al these the Veins and Arteries For whereas the Veins and Arteries run along unto each particular part by the which is received both nourishment and vital Spirit so long as the blood flows in a due measure and just proportion and is conteined within those its receptacles the part is not wont to suffer any Inflammation at all but then only when at the length the blood is overcopiously and all on a huddle emptied and poured forth into the substance of the part by the Veins and Arteries By which very thing also a Phlegmone is distinguished from other fluxions in which the matter is diffused without the Veins into the whole substance of the part and there doth distend and dilate it For in a Phlegmone although all the
unless it make use of the blood for a vehicle or as we say a Conduit-pipe of conveyance and that the acrimonious humor it self excites a pain in that part into which it is thrust and shut up hereupon it is that there follows a conflux of blood unto that part and from it proceeds an Inflammation And much after this manner the Pleurisie the Peripneumonia or the Inflammation and Impostume of the Lungs the Quinsie the Phrensie the Inflammation of the Ears and Gums the hot Tumors or Swellings in the groins called Bubones Carbuncles and such like are generated and excited The Differences The principal Differences of an Inflammation are taken from the variety of the containing cause and from the great difference of the blood that stirs up and begets the Inflammation For a Phlegmone is said to be for distinctions sake either that which is a true and legitimate one or otherwise that that is not a true Phlegmone but rather a bastard and spurious one The true and legitimate Phlegmone is that which proceeds from good blood and such as is in a due natural temper or at leastwise such as whereof there is more than ordinary store and this is absolutely and simply termed a Phlegmone But the spurious and counterfeit Phlegmone is that which hath its rise and original from corrupt and vitiated blood and such as swerves from its natural temperament and this may be occasioned two manner of waies for if the blood doth neither lose its nature nor change its substance but only hath mingled together with it some other Humors then there are three bastard spurious sorts of an Inflammation that thence arise To wit if Choler be mingled with the blood producing an Inflammation it is then called Phlegmone erysipelatodes if Phlegm Phlegmone oâ—dematodes if Melancholy Phlegmone scirrhodes But if the blood change its substance it then excites not any kind of blood-Tumor for the blood as Galen writes upon this very subject in his 2d Book of the Differences of Feavers Chap. 9. if it be overmuch heated and as it may be so expressed boyled to an extream intense heighth then it s more subtile and fat part is converted into yellow Choler but the more thick part into black Choler or as we usually call it the Melancholy humor The Signs Diagnostick The Signs of Inflammation as may be gathered out of its definition are heat pain a swelling and stretching out of the part a renitency or Resistance a redness of color and a pulsation or beating 1. And in the first place in this kind of Tumor there is present so intense a heat that from it the Tumor hath its very name and denomination and many indeed are the causes wherefore this heat is necessarily raised and stirred up For first of all the blood that through its overgreat abundance excites the Phlegmone is hot which heat it also communicates to the part affected Moreover whenas by the plenty of blood and oftentimes likewise by a certain kind of thickness al the pores are so filled up and obstructed that the hot exhalations cannot sufficiently be sent forth and evaporated neither the heat eventilated or cooled as is ought to be the heat by retention of these exhalations and fuliginous vapors is much encreased Unto which also a third cause may be added to wit putrefaction for the blood contained in the inflamed part assumes at length a putredinous quality by which as is to be seen likewise in other things the heat is excited and communicated unto the part inflamed And this heat is somtimes greater somtimes less according to the greatness and growth of those causes The second sign is Pain for whereas there are two remarkable causes of pain an Intemperies or distemper and the solution of continuity they both of them take place in Inflammations For in truth this extraordinary heat by its distemper first of all excites pain and then the abundance of blood by filling ful and distending the part dissolveth continuity and thus doing is the cause of this pain Again the pain that is thus caused is various much different viz. distending or stretching out pulling or twinging pressing and burdening according to the variety of the parts affected but more especially there is present a beating pain which likewise for this very reason is peculiarly reckoned up amongst the proper signs of a Phlegmone and of which more hereafter In the third place a Distension For when the plentiful store of blood doth not only fill the Veins and Arteries but even the whol substance of the part all things are now distended and stretched out but chiefly the skin the which as it lieth round about al the other parts and hath a Membranous substance must necessarily partake of the distension and the extensive pain 4. Fourthly Renitency or resistance or as the Grecians cal it Antitupia in like manner follows upon this repletion and distension For albeit the inflamed part be not hard in its own nature yet it is so stuffed out and distended with store of blood that now it wil no longer answer the touch neither yield thereunto but resist and withstand it and withal it appears hard unto the touch 5. Fiftly the parts inflamed wax red the blood imparting this color unto them For there is nothing in mans body that assumes this redness of color besides the blood and flesh 6. And lastly In the sixth place there is perceived in the inflamed parts a Pulse and beating pain to wit when with grief and extream irksomness there is perceived a bearing of the Artery in the inflamed part which while the part was â—ound was not to be perceived From whence we are instructed as Galen writes in his sixt Book of the parts affected Chap. 7. that this beating pain doth not happen unto al the parts but only to such of them as have in them certain notable and remarkable Arteries The heating pain how it is caused and that have a part endued with an exquisite sense and when the Inflammation is raised up unto a magnitude worthy of observation Now this Pulsatory or beating pain chanceth from hence that when they are lifted up and distended the parts inflamed by reason of their store of blood do not allow nor afford a due free and sufficient room unto the Artery now distending it self but that themselves are rather stretched out by the Artery lifting it self up which said distension excites the pain And this pulsatory pain is then most of al perceived whenas the Inflammation tendeth toward a suppuration For then the blood boyls as it were and grows exceeding hot from whence it also comes to pass that it assumes and makes use of a larger space of room and so much the more distends the part by the which part the Artery is henceforth much pressed kept down in its motion which we cal Diastole and then afterward hereupon the Artery likewise compresseth and bears down the adjacent and neer neighboring parts that lie round
about it The Prognosticks In an Inflammation there are two things that it mainly and principally behoves us to presage to wit The termination of an Inflammation Which is threefold its event or termination and then the exact and punctual time of the said termination Now the Event is said to be good when Nature overcometh the matter that breeds the Inflammation which hapneth when either the Tumor is resolved and the matter insensibly exhaled which is the best kind of solution of an Inflammation or else when the matter is suppurated and turned into that which we term Pus being a thick and purulent matter Or otherwise secondly The event may be said to be evil or if ye wil worst of all when Nature doth not overcome and master he peccant matter which hapneth when the Inflammation if it be external suddenly vanisheth and retires back to the internal parts or when the natural heat being overcome and extinguished the Member thereupon becomes putrified and seized upon by a Gangrene insomuch that if it be not forthwith cut off ruine and death it self threaten the whol body Or else in the third place there follows a Neutral Event as some cal it which is absolutely evil when the Tumor is hardened and when upon the resolution and discussion of the thinner parts the more thick and gross parts remaining behind the Inflammation degenerates into a Scirrhus But now which of these events is to be hoped for or expected may probably be guessed at by comparing together the vigour and strength of Nature with the matter that causeth the Disease For if the matter be not overmuch not thick not over deeply scituated not shut up under a hard and thick skin if the body be not greatly impure and Nature be strong then a resolution and an evacuation by an insensible transpiration may be hoped for But if the matter more abound be more than ordinary thick be contained in a deeper place than usually and be pent up under a thicker skin then a suppuration is to be expected That the matter is retreated unto the inward parts may be conjectured by this token to wit When we perceive the Tumor to be diminished albeit there were no repulsive remedies administred and applied to drive back the matter That the extinction and overthrow of the heat is neer approaching may be presaged by this whenas the heat redness of color pain and the pulse or beating is lessened the Tumor notwithstanding still remaining touching which more hereafter when we shal come to treat of a Gangrene But then lastly an Inflammation for the most part then degenerates into a Scirrhus when the matter is over viscous and clammy and hard therewithal and when the Natural heat being strong and vigorous forthwith even in the very beginning of the distemper remedies that discuss and dissipate over forcibly are thereunto applied which said remedies disperse and scatter the thinner parts thereof and leave the thicker still remaining That the time of the Event may be known The times of an Inflammation it is requisite that the times of the Inflammation be first of all known and they are likewise heedfully to be observed by us upon our knowledg of them in relation unto the Cure For unless the times of an Inflammation be well known and considered we may soon run our selves into an Error whilst we administer and apply Remedies that are any waies improper or incongruous unto any one particular of those several times Now then Inflammations like as all other Tumors and Diseases have four times or periods its beginning encrease state or perfection and its decay or declination It commenceth or begins when the parts are replenished with blood and when the swelling pain and stretching out are encreased this we cal the augmentation The state or perfection is then when the Tumor Distension Pain and all the other symptomes are most vehement and in the heighth of their extremity And lastly the declination is then said to be when the matter generating the Tumor is diminished and the pain heat together with the other symptoms are become more remiss and gentle or otherwise the matter is converted into Pus or purulent matter But the truth is these times are some while shorter somtimes longer and the Inflammations are somtimes sooner and somtimes more slowly terminated For as Galen tels us in the sixth Book of the Aphorisms Aphor. 49. that which is of a thinner substance is in a shorter space digested and that which is thick or tough requires a longer time for its digestion but that which is thick and viscous requires a far longer time And that Inflammation which hath seated it self in the fleshy parts is terminated according to the period of acute Diseases to wit fourteen daies for the substance of the flesh is more soft and permeable by reason of its thinness But the substance of the Ligaments Tendons and Nerves being more thick and hard and thereupon with greater difficulty receiving the fluxion for the same cause also doth with more difficulty discharge it self therof and hereupon the Inflammation in those parts is the longer time ere it attain unto its state and perfection and is not so soon curable but yet notwithstanding the Cure is in this case seldom or never prorogued beyond the term of fourty daies if both the Physitian rightly in al points discharge his part and likewise the patient be in al things willing to submit The Indications and Cure Whereas the containing cause of an Inflammation is the blood which hath preternaturally i. e. beyond or besides Natures intention flown in unto the part the Cure is effected if that blood be removed out of the diseased part and then great caution be had that it thenceforth flow no more unto the part affected that so by this means as wel the containing as the antecedent cause may be wholly taken away For whenas the affect cannot possibly be removed without a first removal of that which causeth it and the case so standing that the causes ought to be taken away in the very same order that they follow one the other in therefore we say that the Fluxion must first of all be extirpated The Cure of a fluxion or flowing of the blood Now this intention may be accomplished if care be taken to prevent the bloods abounding in the body and that that which is there in great plenty flow not unto the part affected The benefit of blood-letting in an Inflammation and this with most safety and speed is to be effected by opening a Vein For by this Venesection or blood-letting the great store of abounding blood is diminished and the same is likewise drawn back from the aggrieved place hence it is that there is an exceeding great benefit arising from and following upon this opening of a vein in an Inflammation so that it is seldom or never to be omitted if the strength of the patient wil permit it to be done And indeed hardly can
it as being such as is produced by the most corrupt blood The next unto this is the wan and yellowish Those that are less malignant and consequently the less to be feared are such as have in them a reddish color to wit such in which the blood hath not as yet altogether lost and changed its Nature but that it hath as yet retained somwhat of its native heat and color 2. Those Carbuncles likewise that are smal are less pernicious than those that are great and from a very little Pustule they suddenly acquire and get an extraordinary greatness 3. And so are likewise those that are alone than such as have other Carbuncles conjoyned with them 4. Of al other those are most destructive and deadly which after they have once begun to wax red do immediatly vanish again For the matter being transferred unto the more inward parts often if not evermore proveth destructive and deadly 5. There are some also who conceive that this is likewise throughly to be considered to wit Whether the Pestilent Carbuncle arise before the Feaver or else whether or no the Pestilent Feaver going before it at length break forth For they conceive that the Carbuncle that breaketh forth before a Pastilent Feaver is more safe provided that no Symptoms follow thereupon in regard it is an evidence that Nature is strong and able to expel the Pestilent Poyson before the Feaver ere ever it can seize and surprize the heart And on the other side that to be more dangerous which at length breaketh forth after a Pestilent Feaver forasmuch as the Heart being seized upon it hath its original from the poyson and the corrupt humors now diffusing themselves into al parts of the body 6. The place also manifesteth when the danger is more or less to be feared For those are evermore accounted evil and pernicious that stick fast in the Emunctories and neer unto the Noble and Principal Members But here most especially the strength and natural powers are to be regarded and we are wel to consider whether they be strong or else but weak For that strength that is but weak and languishing may be soon over-powered and vanquished even by a smal Disease Whereas on the contrary that that is more vigorous oftentimes overcometh and mastereth even that disease that in it self is strong and powerful The Indications The Indications in a Pestilent Carbuncle are different from those in a Carbuncle not pestilent In a Pestilent Carbo or Carbuncle the fervent heat of the blood is wholly al the body over to be restrained and withal the Heart at the same time is to be fortified against that malignity which as we have said is here very seldom absent The rest of the Cure is to be directed unto the Carbuncle it self But now in a Pestilent Carbuncle there is a more poysonous and pestilent quality appearing than in the fervent heat of the blood yet neither is this to be sleighted or neglected The Cure And therefore as to what belongeth unto the Cure of a Carbuncle there are two things that we are especially to regard and have an eye unto the Antecedent Cause or the fervent and corrupt blood that is in the whol body and the Conjunct Cause or that same Humor that now exciteth the Carbuncle A convenient Diet therefore being ordained and a moderation observed in those things we cal not natural the extream fervent heat of the blood is by opening a Vein to be taken away And yet this Venesection is not rashly to be made use of in al manner of Carbuncles but if it hath any place at al it is most chiefly in that that is not pestilent touching which likewise that assertion of Galen in his fourteenth Book of the Method of Physick and of other Authors who conceive that the blood is to be drawn forth even until the sick person faint and swoon is to be understood But in a pestilent Carbuncle nothing is rashly to be attempted that may weaken and deject the Natural powers of which there ought to be the most special regard had in the plague and in pestilent Feavers amongst the which Venesection unto fainting and swounding is not the last but rather the first which together with the Spirits evacuateth that humor that is most agreeable and friendly to Nature and even that most excellent and precious Treasury of the life Nay indeed moreover even somtimes when the pestilent Carbuncle is just then breaking forth we cannot safely enough institute and ordain Phlebotomy For whereas the Carbuncle somtimes breaketh forth not instantly upon the very first invasion of the Plague and pestilential Feavers but often afterward on the fourth daies or haply on some other daies the Natural powers wil not then bear the said Venesection in regard that they are now dejected by the disease and have therefore entered the Lists are now conflicting with the said disease But now what Veins are to be opened sufficiently appeareth from that which we have spoken above touching the evacuation of the blood touching Revulsion and Derivation in the Cure of an Inflammation This only is here to be observed that we must beware lest that whilst we evacuate the blood we do not lead and draw the same either unto any noble Member or else through any noble Member lest that the said Member should be affected with its malignity And therefore we say that that Vein is to be opened by means whereof the blood may rather be drawn toward the part affected than drawn back from it Wherefore if the Carbuncle shal be about the Head or the Arm-holes or in the Breast the neerest Vein in the Arm of the same side is then to be opened But if it be below the Liver then the Ankle Vein or the Ham Vein of the same side And this Phlebotomy ought to be put in practice instantly and in the very beginning before the Feaver get strength and the Natural vigor be too much dejected But now in regard that by this blood-letting the naughty corrupt humors can scarcely be evacuated therefore some conceive that there is need of purgation by which the said depraved humors may be evacuated lest otherwise the Native heat should be suffocated and extinguished by them and that Nature may afterward the more rightly moderate the expulsion and that so the part affected may not be corrupted by the great abundance of the Humor flowing thereto But then we ought to be extraordinary careful lest that by the purging Medicament the Humor that Nature endeavoreth to thrust forth unto the external parts be drawn unto the internal and this is most of al to be feared in a pestilent Carbuncle We conceive indeed that it may more safely be ordained and appointed in a Carbuncle that is not malignant But when a Feaver is therewith joyned and that an acute one the crudity of the matter then for the most part forbids it and to speak truth there is hardly a Carbuncle to be found in which
there is not somthing of malignity and therefore the malignant matter is with more safety thrust forth unto the superficies of the body by those Medicaments we term Alexipharmaca then drawn to the more inward parts by Medicaments that purge That fervent heat also of the adust blood is to be altered and the malignity to be opposed by convenient Medicaments as the juyce of Citron of Pomegranates Sorrel Borrage Bugloss Water Germander Succory and the like with which in a pestilent Carbuncle other Alexipharmaca may also be firly mingled As Take Conserve of Sorrel Borrage Bugloss of each one ounce and half the species of Diamargarit frigid Confection of Hyacynth Elect. de Gem. of each half a dram of candied Citron rind six drams the candied roots of Scorzonera or Vipers Grass half an ounce with the juyce of Citron make an Electuary Unto which in a Pestilent Carbuncle we may add Bole-armenick Terra Sigillata or sealed Earth Harts horn Bezoar stone and the like Very many there be that in a Carbuncle do much commend Scabious and they conceive that it never ought to be passed by and they write that either the Juyce or the Water or the Decoction thereof is of singular use and benefit in a Carbuncle It wil not likewise be amiss to fence and guard the Heart with Topicks by Epithems that are otherwise known applied to the Region of the Heart and the Pulses that so by all manner of means the Heart may be preserved safe and sound from all the malignity Afterward as for what concerns the conjunct cause or the Tumor it self the way and means of curing a Carbuncle is not altogether the same as in other Inflammations unless haply there appear to be in it very little of an offensive quality Neither must we make use of Repellers but the malignant and poysonous matter is rather to be attracted from the more inward unto the external parts unless perhaps they may be administred for the mitigating of the vehemency of the pain touching which more hereafter And therefore so soon as Venesection hath been administred the part affected is forthwith to be scarified and that likewise with lancings that go deep enough that so the corrupt malignant and poysonous blood which unless it be instantly emptied forth of the part affected corrupteth the parts neer adjoyning may be quite drawn forth Immediately upon this the part affected is to be cleansed and throughly washed with warm salt water or with some other convenient liquor lest that the blood should clod and so grow together in the part Now if the corrupt blood seem not as yet to be sufficiently evacuated the scarifications ought then to be repeated We are likewse allowed when the place is scarified to apply thereto Cupping-glasses or Leeches Yet notwithstanding iâ— with great violence the humor flow unto the part then Atrractives may not safely enough be administred since there is cause to fear lest that the matter flowing thereto in great abundance the pain should be made the more vehement which may possibly excite and cause watchings augment the Feaver and deject the Natural vigor but rather if the matter flow thereunto over hastily and with too great force we are then to make use of those Medicaments which by moderate repressing and driving back may likewise digest And such is the following Cataplasm Take Arnogloss we commonly term it Lambs-tongue or Way-bread Lentiles Bread that is neither wholly purged from its bran neither yet such as is altogether branny of all these a like proportion let them boyl in Water or Wine and so make a Cataplasm which is to be applied twice or thrice every day But now this said Medicament that we have mentioned or such like is not to be imposed and laid upon the very Carbuncle it self but only neer about it some three fingers distance from it For by this means the malignant matter it self is not driven back but only the extream heat and pain is mitigated the flux of matter is somwhat retarded and hereby is prevented the retreating back again of the matter unto the more inward parts But yet neither must this be passed over in silence that it is not evermore requisite to fence the Carbuncle with such a guard but notwithstanding this for the most part iâ— necessary to wit That that part which hath a neer relation with a noble Member should be wel guarded forasmuch as it is no way hurtful but indeed profitable that some of the matter should be derived and evaporated unto the other ignoble parts Moreover the place being scarified there are not to be applied those Medicaments that otherwise are wont to be laid on in regard that they promote and further the Pus or purtilent matter and by this means may encrease the putrefaction and rottenness since that a Carbuncle in putrefying evermore creepeth and spreadeth so that very often a Mortification chanceth unto such parts but rather those Medicaments that are drying and such as resist putrefaction For which end and purpose we may administer the Pastils or Pomanders of Andro Musa Polyidas and Pasio which are to be dissolved first of al in Wine and then also afterward in Vinegar touching which see Galen in his Composition of Medicaments in general the fifth Book Chap. 11 and 12. They commonly likewise make use of the Aegyptiack Unguent There may also be made a Cataplasm of the Meal of the Pulse Orobus with Oxymel Morsus Diaboli or Devils-bit is likewise very much commended if while it is yet green and wel bruised it be laid on or else boyled in Wine and drunk There be many likewise that here make use of those things that are experimentally found to be helpful by the propriety of their substance among which Scabious is especially commended as also Morsus Diaboli or Devils-bit they take to wit the Scabious whilest it is green and bruise it wel and then they add thereto the Yelk of an Egg Hogs grease that is old and a little Salt and herewith they make a Cataplasm which is often to be renewed Some likewise take the Herb Comfry for the same use and with it they prepare and make such a Medicament as this that followeth Take of the Juyce of the greater Symphytum or great Comfrey Scabious Cranes-bill or Doves-foot of each one ounce of Barley Meal two ounces and an half and mingle them for a Cataplasm Others there are who if there be present an extream heat and pain commend this Viz. Take Plantane Leaves and Sorrel Leaves of each two handfuls boyl them to a softness then let them be bruised when they are throughly bruised add to them the Yelks of four Eggs Treacle two drams Barley meal a sufficient proportion and so make a Cataplasm Many likewise there are that commend those Wallnuts that are old and Oyly being bruised of the which some make such a Cataplasm as this that followeth Take the Kernels of Walnuts such as are old and rancid or mouldy in
therefrom Touching the Quartan we have spoken before where we treated of Feavers There are oftentimes other Feavers long continued and sufficiently dangerous and likewise very often intermingling Feavers but for the most part they are inordinate Feavers that arise in this manner and by this means Of this I here cured in the yeer 1636. in the month of April a certain man of a melancholy Constitution An example of a continual Feaver from the Scabs retiring inwardly and who had withal likewise a continued Feaver together with a sore and very grievous Cough by means of which he cast forth and brought away much Spittle and somtimes also great store of blood he was likewise afflicted with a difficulty and shortness of breathing insomuch that there was now great cause to suspect and fear a Phthisis or Consumption Now having for eight daies made use of Medicaments to very little purpose I made a further and more strict enquiry into the Cause of the Disease and then the Patient gave me to understand which until now he had concealed from me that before he was taken with this Disease he had the Scabies or scabbiness as we cal it the which was no sooner vanished and gone but this Feaver and Cough followed thereupon The which I no sooner came to understand but that I used the utmost of my endeavor by Medicaments made of Fumitory and such like to cause the Scabs again to break forth Which I had no sooner effected and administred such other Medicaments as I thought fit but both the Feaver and the Cough ceased and the man is yet living and perfectly sound without any the least fear of a Consumption I have told you elsewhere of a certain Student Another example of blindness from the same cause this man affected with this Scabies after and immediately upon the striking in of the Scabs became instantly blind and for two daies could see nothing at al this his blindness was likewise accompanied with an extraordinary streightness of the Breast difficulty of breathing and black Urines This man upon the use of fit and convenient Medicaments that were administred to evacuate the adust humor as Fumitory and such like within four daies recovered his sight again The same party a quarter of a yeer after being again afflicted with the same Malady did not lose his sight as formerly And likewise of the Epilepsie but had one fit of the Falling-sickness But yet notwithstanding having had fit and proper Medicaments prescribed him he again recovered I have likewise seen many that from Scabbiness have been surprized and invaded with prickings and shootings in the Breast And many other discommodities and inconveniences arising from the same cause with the bastard Pleurisie and dangerous stitches and likewise with the Cachexy I knew also a youth aged fourteen yeers that upon the unseasonable use of inunctions against the Scabies to made his Urines black lost his sight and at length being seized upon by the Epilepsie and the fits thereof being become very frequent in the end he died thereof Wherefore we say that this Scabies is no way to be sleighted neither driven inwardly or up and down and if it arise from any internal vice of the humors and the Cacochymy then externall Medicaments are by no means to be administred before the use of Purgers and other internal necessary Medicaments But now what hath been said touching the Scabies or Scabbiness The same is likewise to be taken and understood touching the Achores in Infants the same is likewise to be asserted touching the Achores or running sores in the Head yielding a thin excrement in Infants Concerning these Hippocrates in his Book of the Epilepsie or Falling sickness which he calleth Morbus Sacer writeth thus Those Infants saith he that have Vlcers breaking forth upon their Heads and upon their Ears and upon the rest of their Body and such as spit often and abound with Snot these are they that in the progress of their age live most at ease For hither floweth and from hence is likewise purged forth that Flegm which ought to have been purged in the Mothers Womb and these Infants that are thus purged are never seized upon by the Falling sickness Whereas on the conâ—rary iâ—â—â—ther the Physitians or the Women-Doctors as they call them do without due caution and unseasonably administer astringent and Repelling Medicaments and therby heal up the said Achores the Infants must then unavoidably fal into Feavers the Epilepsie Convulsions the vitious humor retiring and running unto the internal parts and somtimes likewise they within a very short space even die hereupon The Cure Now therefore in the first place there is a due care and regard to be had in point of Diet and there must be a totall abstinence from those Meats that generate adust and salt humors Viz. all things that are salt sharp bitter Oyls themselves and whatsoever partaketh of an oyly Nature and on the contrary Meats of a good and wholsom Juyce are constantly to be fed upon And this may also be observed and taken for a general rule that it is more convenient that the food that is given unto Persons that are thus affected to wit with Scabbiness be rather boyled than either rost or fried For what is either roasted or fried doth especially generate a more sharp and dry humor After this the acrimony sharpness of the humors is to be qualified and tempered and the distemper of the Liver is especially to be reduced unto its pristine Natural state and the salt and sharp humors are likewise to be evacuated And therefore in the very beginning the first waies and passages as we term them are to be purged and emptied as for example Take Electuar Diatholic half an ounce Powder of prepared Sene half a dram and so with Sugar make a Bole. If there be present any extraordinary store of Blood that the humors are overhot it wil then be very requisite and proper to open a Vein in the Arm. For Nature is wont to expel the vitious humors out of those greater internal Veins unto the external branches and those that lie under the Skin which from thence a Vein being opened are together with the Blood evacuated Afterwards in a moist Scabies from salt Flegm Preparatives are to be administred of Cichory Agrimony the Hop and Maiden-hair and Purgers of Agarick Rheubarb and Sene Leaves In a dry Scabies Preparers of Fumitory Borrage Bugloss Violets and Purgers of Epithymum we commonly call it Mother of Tyme Polypody Sene black Hellebor from whence for this present purpose various forms and Receipts may be made and compounded As Take the Roots of Cichory one ounce Polypody sowr Sorrel the inward rind of the black Alder Tree of each half an ounce of Sassafras wood rasped Liquorish of each two drams Fumitory Sorrel Agrimony Scabious of each one handful Epithymum the Flowers of Borrage and Bugloss of each half a handful Raisins
now this humor is diffused thorowout all the Veins and an inductive Feaver is dispersed without any putridness at all thorowout the whol body and is mingled together with the aliment But now there are many things that conduce and make to the generation of this humor There are some that contract the original seeds of this Malady from their very birth to wit such as either are born of Elephantiack Parents or else conceived during the Flux of the monthly Courses vitious and corrupt and declining unto black Choler And moreover also the hot and dry distemper of the Members destin'd by Nature for Nutrition as for example the Liver and the Spleen from whence it is that the Blood and the humors are burnt is deservedly reckoned up and accounted among the Causes of this Malady And furthermore the frequent and common use of salt meats maketh likewise very much hereunto as also the eating of sharp and sowr meats and food that is overgross and thick the Air also being overhot and dry or else thick and Cloudy from whence it is that this Malady is in some Countries more frequent and usual and in other Regions scarcely known as the Poet Lucretius tels us in his sixth Book Elephas saith he is a Disease that by reason of the overflowings of the River Nilus is bred in the midst of Egypt and no where else But although it be true that the Disease is more frequently found there as Galen likewise testifieth in his second Book to Glauco and Chap. 10. where he acknowledgeth that in Alexandria by reason of the fervent heat of that Region and the unfitting Diet of the Inhabitants who eat Meal boyled Lentiles and Cockles many salt meats and the flesh of Asses with divers other sorts of food that generate and breed a thick melancholly humor there are more that are troubled with this Elephantiack Disease yet notwithstanding it is also to be found in other Regions In Germany especially in some parts thereof these Elephantiack Persons are very common and ordinary but in Spain and Africa they are far more frequently found and in Gallia Narbonensis and Aquitain there are more of them to be found then in al France besides Pliny in his twenty seventh Book and Chap. 1. writeth that before the time of Pompey the Elephantiasis was never known to happen in Italy Living and Conversing likewise with the Elephantiack Persons much conduceth to the causing of the Disease For the Air that in breathing is attracted and drawn in is infected by the stench of the Members and the vitiated exhalation of the Breath From whence it is that men deservedly shun the company of those that are thus affected and for such as are domestick and therefore necessarily constrained to abide under the same Roof do yet as there is good reason for it shun their company and all neer Converse with the sick Persons and therefore even for this cause it is that these Elephantiack Persons are separated from the society and company of others and are sent away and disposed of in some open places in the which they live with most benefit unto themselves and less endangering others But especially carnal copulation with the Leprous man or Woman is undoubtedly dangerous and infectious and so is likewise that carnal society that any one hath with her that before hath had to do with a Leprous man Unto these same Causes there belongeth also the retention of the Melancholly Excretions as the suppression of the monthly Courses and the Haemorrhoids and the sudden stanching and drying up of long continued Ulcers For such a like humor as this if it be deteined long in the Body becometh worse and worse dayly and at length acquireth this malignity and being reteined in the Body it seateth and setleth it self in the Veins and infecteth the whol mass of Blood Moreover this Malady doth more frequently invade and seiz upon men then women and among men those especially that have in them Blood that is thick and viscous tending to black Choler and such as use a thick and inordinate kind of Diet. Signs Diagnostick Although as for what belongs to the signs of this Malady we have given you some few of them out of Celsus as they are by him recounted and reckoned up yet notwithstanding it wil not be time pains ill spent to enumerate and declare the whol entire History of the Signs and Symptoms And therefore in the first place whensoever this Malady is nigh at hand there immediately goeth before it and is present a sluggishness or slothfulness and slow and difficult breathing unfitness for motion a dayly and continual costiveness of the Belly Urines like unto the stalings and waters that come from Beasts and the greater Cattel a Breath slow and stinking and an extream propension to Venery When the Malady hath once gotten forward into the Skin then the Native and flâ—urishing fresh colour of the Face is changed there arise red blewish and wan Pustules the Cheeks and the Chin become thicker the Veins under the Tongue are swollen up and wax black the Hairs fall off there is present an extraordinary Thirst and a driness in the mouth both by Day and by Night But now as it is in other Diseases so it is here that there are likewise certain times of this Malady The beginning is when the vitious humor and the malignity is yet but as it were laying siege and beleaguering the Bowels The increment or increase when the Malady now shews it self abroad and openly and that the Symptoms are daily augmented The state when the Members are exasperated and the whol concourse of the symptoms appeareth publickly the which we shal immediately subjoyn First of all the Eyes appear exactly round and the looks thereof are fixed and immovable which happeneth by reason of the consumption of the fat and the extenuation of the Muscles the Eye-lids and the Ears are contracted and drawn together the Eye-brows fall down the Nose swelleth outwardly and is made flat by reason of the afflux of the humor and it is streightened within from whence it is that the passage is obstructed and the breathing hindred so that they seem to speak as it were through their Noses the colour of the Face is wan and Leaden coloured the aspect and looks frightful there appear Tubercles and red Pustules under the Eye-brows about the Ears and in â—ivers places of the Face and knots hard and round like unto Grains the Lips are made thick the Bones neer unto the Ears stick forth the Hairs of the Head shed and fall away and if the Hair be pulled forth a part likewise of the white Skin is pulled away together with it which is a most certain and infallible sign of the Leprosie This Malady discovereth it self likewise in other parts the Veins under the Tongue swel and become blackish and the Glandules that lie neer unto the Tongue and round about it have in them round Tumors like unto the
malignant Ulcer they are by no means to be healed lest that these being removed some more grievous Evils befall Since that those things only may be said to heal that do altogether free the Party and not those things that generate another Affect more dangerous then the former as Galen teacheth us in the sixth of his Aphorisms Aphor. 26. And therefore if it like you to Cure these Varices this ought to be done with great Caution there must be some of the blood let forth the Body must then be purged and that not only once but twice or thrice and whatsoever is amiss in the Liver and the Spleen if they be ill affected and administer cause unto the Varices is first of al to be corrected And afterward we are to make use of Astringent Drying and Digestive Medicaments as also of Swath-bands and Ligatures that may thrust forth the blood from the inferior parts unto the superior These things if they profit not but prove successless the Ancients were then wont to betake themselves unto Section or Cutting Oppius is our Author as Pliny relateth it in his eleventh Book and Chap. 45 that Caius Marius who had been seven times Consul was the one man that standing suffered these Varices to be taken out of him the one man saith he I cal him because that as he was the first so he was the only man in those times But after him there were others also that suffered the same to be done unto them standing and even without any bonds For so Cicero tels us in the second Book of his Tusculane Questions towards the end thereof But in good truth saith he Caius Marius a Countrey-man but yet a man every inch of him when he was cut of the Varices at the very first forbid them to bind him Neither before Marius was there ever any heard of that was cut without being bound Why therefore were others afterwards His Authority and Example caused it so to be Seest thou not therefore that the Evil of this Affect was more in Opinion then it was really and in Nature And yet notwithstanding that this Affect was not without its sharp biteing pain the same Marius sheweth for he yielded up only one Thigh whereas they were both of them affected to be cut and not his other Thigh that ailed altogether as much so that he as a resolved man was contented to suffer pain but then as a Rational Man he refused to undergo a greater pain then there was necessary Cause for the whole of what thou art taught by his Example consists in this viz. that thou carry a Commanding power over thy self And of the same thing Plutarch writeth in the life of Caius Marius He may be for an example unto us saith Plutarch in that when he was diseased in both his Thighs and having them bothful of these Varices and bearing the deformity of them with a very ill will he took unto him a Physitian for the curing of one Thigh only in the cutting whereof he did not so much as blinch or once stir his body neither was he heard so much as once to sigh but when in silence and with fixed Eyes he had rendred himself to be cut he was not at all affraid during the time this cutting took up to suffer and undergo certain intervals of pains caused by pauses and delaies But yet he would not in the least consent unto the Physitian requiring him to render yield up his other thigh to be cured but thus he said I know wel that the Remedy can no waies countervail these so great pains And haply these are those things of which Seneca in his eleventh Book Epist 79. saith He that whilest he was suffering those Varices to be cut forth continued al the while reading of a Book But yet at this day there is hardly any one that wil admit of this Remedy for the removal of that deformity that is caused by these Varices As for the manner of cutting them out Paulus Aegineta in his Book 6. Chap. 82. teacheth us how it ought to be performed The man being washed saith he and a string tied about on the upper part of his Thigh we command him then to walk and then when the Vein is filled ful with writing ink or with a Colliry we mark it according to its scituation the length of three fingers or somewhat more the man being then laid upon his back with his Thighs extended we then bind about another String above the Knee and by this means the Vein being elevated into a considerable heighth we cut with a Panknife in that very place which we marked no deeper then only through the Skin that so we may by no means divide the Vein and then the Lips of the Section being distended with little hooks and the Membranes being excoriated and fleyed off by those crooked Penknives that are provided in Watery Ruptures and the Vein being altogether made bare and naked and laid open to the view on all sides we then loosen the Thighbands and the Vessel being elevated by a little hook we cast under it a Needle drawing along in it a double Thread and cut in two the nook of the Thread and then the Vein being divided in the midst by a Venesectory Penknife we evacuate and let forth as much of the blood as is needful then after this with one of the threads we tie close together the upper part of the Vessel and the Thigh being extended straight forth by the expression or hard pressing of the Hands we empty forth that blood that is in the Thigh and afterwards we again beneath tie the vessel close together or we cut off and take quite away that part of the Vein that lieth between the bonds or otherwise we permit it to remain until that at length together with the bonds it fal out of its own accord then putting in dry Liniments and a long spleen-like Emplaster after it hath been throughly moystened in Wine Oyl being laid thereupon we bind it down close and so we cure it by the continued course of suppurating Medicaments that are to be administred and applied in the nature and after the manner of Liniments Neither am I ignorant that some of the Ancients used none of these bonds and Ligatures for some of them presently cut forth the Vessel so soon as ever they had made it naked and bare and certain others of them with violence draw forth and break off the said Vessel so soon as they have extended it from the bottom But the truth is that before mentioned way of Manual operation is absolutely the best and of all other the most secure Moreover as for the Varices that consist in the bottom of the Belly we handle them in like manner as likewise those that consist in the Temples Thus far Aegineta Cornel. Celsus in his seventh Book and Chap. 31. telleth us of a twofold manner and Method of curing these Varices by Chirurgery when he
in the Stomack and that accordingly blood be bred in the Liver yet it is oftentimes discussed and wasted by some certain Causes such as are overmuch exercise Watchings Cares Griefs and Diseases which melt away dissolve and discuss the aliment so that there is too great an evacuation hereof by the Belly by Sweats and by the flux of Blood and such likewise are immoderate Rest Meats and Medicamens that dry excessively Fevers especially such of them as are acute and Malignant But the Nutriment is not rightly assimilated by the parts in regard of some vitious quality it hath in it by reason of which it cannot be assimilated by the parts and so likewise the Nutrition may be frustrated by some external error or else by reason of the Object to wit because the Blood is such that it cannot by the nourishing faculty be perfectly overcome and assimilated But now in regard of the faculty there is not a sufficient Nutrition â— In regard of the nourishing faculty by reason of some defect and want of native heat and radical moysture For Nature maketh great use of this Native heat as of the next instrument in nourishing And this especially happeneth by reason of the preternatural affects of the Heart and principally its heat and driness whether it be that the Heart be primarily affected as it is in the Hectick Fever or else that it suffer through some default of the neighboring parts as it happeneth in the Ulcer of the Lungs For whereas the nourishing faculty as we said erewhile maketh great use of the innate and Native heat as its principal Instrument in reteining Concocting agglutinating and assimilating and it being so that the innate heat is cherished by the heat that floweth in if the temper of the Heart be not right and as it ought to be then the heat that floweth in and consequently the innate heat likewise wil be much amiss and not rightly tempered and so it can be no fit Instrument of the nourishing Faculty And that that Hectick Feavers do but slowly and sensibly bring to pass this the burning and melting Feavers accomplish in a very short time by the heat whereof not only the aliment and substance of the body is consumed and melted away but likewise the temperament both of the Heart and also of the whol body is converted into that which is more hot and dry The same happeneth by reason of over hard labors cares long continued diseases and in general al causes that are able to consume the Radical moisture and weaken the Native heat Now this Atrophy happeneth especially in the softer parts The subject the fat and the flesh and indeed the fat is first of al wasted and then afterward the flesh is likewise extenuated But now as for the harder parts such as are the Membranes Cartilages and especially the Bones although these may also in the like manner be dried yet notwithstanding they cannot possibly be so extenuated and diminished that thence the whol body should decrease And hence it is likewise that the said extenuation and Atrophy of the body doth appear especially in those parts in which there is much fatness and where there are more or greater Muscles as in the Eyes and Temples The particular Atrophy The Atrophy that happeneth in the parts is various It happeneth oftentimes privately in the Limbs the Arms and the Thighs And hither belongeth the Atrophy of the Eye The causes thereof which are the same As for the Cause of the particular Atrophy like as the Causes of the Atrophy of the whol body consist in some one principal Bowel whose action is necessary for the nutrition of the whol Body or is indeed universal and such as may exsiccate and dry the whol body so in like manner the particular Atrophy of any one part hath a private cause or at least such a one as belongeth unto that particular part Yet notwithstanding the Causes are the same as of the universal Atrophy to wit the weakness of the Nutritive Faculty The weakness of the Nutritive Faculty and the defect of Aliment The Faculty is hurt when the part is over cooled and left destitute of its proper heat For if this happen the part can neither attract nor retain not alter nor assimilate the Aliment Now the part is refrigerated and the heat decayed and rendered dul and unfit for action not only from the external Air as also from cold water but likewise it may proceed from overmuch rest in the Palsie or else from the streightness of the passages through which the Spirits flow in The defect of nutriment The Nutriment faileth especially by reason of the narrowness of the passages through which it floweth unto the part that needeth it And this happeneth for the most part from external causes when the Veins that carry the blood unto the part for its Nutriment are pressed together by the bones when they are loosened and out of joynt or else from some certain Tumor that is nigh unto it or by the brawniness and hardness of the flesh or else lastly when the Veins that convey the Nutriment are cut in sunder See likewise Galen's Book of Marcor a Species hereof arising from an Hectick Feaver Signs Diagnostick The extenuation of the whol body as likewise of some one particular part thereof is visibly apparent to the sight so that there wil be no need of many signs For if the whol body be greatly wasted by an Atrophy then the Face fals away and becometh lean the Temples fal down the seat of the Eyes is rendered hollow and deep the Nostrils become sharp and such kind of Face because that Hippocrates describeth it in his Prognosticks they commonly cal an Hippocratical Face Al the Ribs are conspicuous the shoulder blades and the Chanel bones stick out the Neck is extenuated and the Larynx or the top of the cough Attery buncheth forth the Belly falleth down the Buttocks become withered and weak the Thighs Arms Hands and Feet are emaciated and grow lean But in regard that the Atrophy hath its dependance upon many and several causes they are therefore al of them to be inquired into that so the Cure of them may the more rightly be proceeded in And therefore enquiry must be made whether external Causes to wit tasting cares grief over hard labor and the like went before If we find no such thing we are then to make enquity into the internal Causes to wit whether there be present a Hectick or any putrid Feaver or whether there had not been one a little while before and likewise a discovery must be made touching the Stomach Spleen and Liver in what state and condition they are for by the Diseases of the Bowels it may easily be known what the Cause of the Atrophy is Prognosticks 1. By how much the more the Atrophy is but recent and newly begun by so much the more easily it is cured but by how much the longer it hath
whenas yet notwithstanding it is no way credible that there were no such Affects as these among the Ancients for there were then rise in those times the same causes as now There is commonly known an Affect which the Germans cal Leberflecke without al doubt The Affect Leberflecke what it is in regard they beleeve that it hath its original from the Liver to wit dark and brownish spots or such as of yellow become somwhat blackish as broad as the Palm of the Hand seizing upon the Groyns especially and the Breast and the Back yea and somtimes also covering the whol Breast with a certain sleight roughness of the Skin that sendeth forth as it were scales or branny scurfâ— which yet notwithstanding do not stick and abide in one place alone but are dispersed hither and thither and one while they vanish another while they break out and appear again Reinerus Solenander of al that I can remember doth most plainly and cleerly describe unto us these spots in his Sect. 5. Consultat 11. but yet he gives them no name And Platerus likewise seemeth to make mention of these when he writeth that there are some certain dark brownish and dun spots as broad as the palm of the hand arising somtimes in some certain parts of the body and at some certain times only and vanishing also at some certain seasons But he maketh the matter somwhat obscure and doubtful in bidding us to seek for the cause and for the Cure in the Lentigo For these Lentigines and the spots we now speak of are different Affects and they have different Causes as wil further appear from those things that have been already spoken of before in the third Chapter touching the Lentigines and shal be more fully spoken of in this present Chapter Whether these kind of spots may not be referred unto the Vitiligo and the black Alphus as I think that they wel may I leave it unto the judgment of the Reader Our purpose is here in this Chapter to explain and treat of this Subject without either the Greek or Latine name for the German name is of al others the best known as are also the very spots themselves The Causes The Cause of these Spots is a humor very dry and Melancholy brought unto the Skin together with the aliment of the parts or alse blood that is feculent ful of dregs and very thick which when it cannot al of it be assimilated that of it that is excrementitious is thrust forth unto the Skin But although that more feculent blood may be generated from an overdry Liver from whence it is that by the Germans it is called Leberflecke that is to say Liver-spots yet nevertheless seeing that the Liver doth its office in its sanguifying faculty and breedeth good blood the Spleen without doubt is not altogether free from fault Whereupon I have observed that after those spots if they have continued long Quartan Feavers have arisen An unfit kind of Diet and such a course of life as is apt to breed a thick and feculent blood and a Melancholy humor maketh very much likewise for the generation of these spots touching which we have already spoken elsewhere Prognosticks 1. These very spots indeed have in themselves little or no danger neither do they breed any kind of trouble or any deformity visible unto the eye when they arise in the Face and Hands as the Lentigines but in those places that are covered wich Clothes 3. And yet notwithstanding in regard of the Cause upon which they depend and the vitious Constitution of the Liver and Spleen they presage other Diseases and very frequently Tertian and Quartan Feavers follow these Spots 3. Although those Spots may easily be taken away as anon we shal shew you yet nevertheless unless the fault and imperfection of the blood and bowels from which the vitious blood is generated be taken away they again return and flourish in a short time after The Cure Since therefore these kind of Spots being taken away may again return unless the Cause upon which they depend be likewise taken away the vitious humor is therefore to be evacuated by Medicaments that are made of the Roots of Polypody Succory Borrage Spleenwort Dodder Maiden-hair Egrimony the Leaves of Sene Rheubarb Jalap And this is somtimes to be repeated and if there be occasion a Vein may likewise be opened But then in regard that these Purgers do evacuate only those humors that are collected in the Veins but do not prevent the generation of the said humors we must therefore more especially do the utmost of our endeavor that the vitious Constitution of the Liver and Spleen upon which the breeding of these humors doth depend may be amended and this may be performed by a good and wholsom dyet by the which that dry constitution of the Liver and Spleen may by degrees be restored unto a better condition And therfore we are to prescribe Meats of a good Juyce such as Goats flesh Veal Lamb Pullets Eggs and the like Barley Wheat Apples throughly ripe Prunes Raisins Almonds But the Patient must avoid meats that are thick salt sharp and generally al meats of an il juyce such as are flesh that is smoke-dried and the like For the Constitution of the Bowels being by the use of good meats reduced unto a better estate and condition the vitious humors wil no more be generated but only a good and temperate blood But as for what concerneth Topicks it wil be very good in the morning to rub those parts that are thus defiled and deformed with spots But first of al before the Patients going into the Bath it wil not be amiss to take the Water or the Syrup of Fumitory with a little Treacle After his sweat let the place be anointed with Mustard seed with warm water reduced into the form of a Pultiss which may be there left to continue so long even until that a heat and a certain pricking be felt and perceived in the part and afterward let it be washed with warm Water Or else let it be anointed with this Mass Take White Sope half a pound let it be sliced and dried and afterwards add of Mustard seed one dram and half the meal of Beans and Lupines of each two ounces the soft Crumb of white Bread one ounce with the juyce of Fumitory or the sharp-pointed Dock mingle and use it Chap. 8. Of the Itch. ALthough that the Itch may be joyned together with many other Affects as Scabs the Impetigo Leprosie and the like so that these being taken away this very Affect is likewise removed yet notwithstanding it somtimes singly and alone vexeth and troubleth persons and so troublesom it is that the party thus affected is often enforced to implore the help and assistance even of the Physitian also and of this we intend to treat here in this Chapter Now the Itch is a pain that is excited from a thin and sharp excrement sticking between the Scarf-skin
distemper of the Bowels and maketh for the generating of good blood is a fit and proper Course of Diet. Lee the Air be temperate inclining unto cold and moist and the Meats of a good Juyce of an easie Concoction and that are not easily corrupted these may be altered with Borrage Endive and especially Lettice which last procureth also sleep which in this Affect is very requisite and useful But all such meats as are Sharp Salt Bitter Sour Sweet Fat and most of all fried meats are to be shunned and avoided As touching Topicks for the mitigating and moderating of the Itch it self and for the tempering of the humors Acrimony and likewise for discussing of the humors a Bath of sweet Water made blood-warm is of singular use in the which the sick Person may sit for half an hour or a whole hour in the morning fasting because that it doth at once temper the heat and driness of the Bowels and withall rarefie the Pores But the Medicinal Baths to wit those of Sulphur c. are more useful in the stronger discussing of the matter and it wil not be amiss by turns one while to make use of a Bath of sweet blood-warm Water and another while of that that is salt and sulphury For so by this means both the Itch shal be mitigated the Pores loosned and the excrements in the Skin Cleansed away and evacuated But for discussion we may likewise make use of either common Oyl or Oyl of sweet Almonds with Salt and Sulphur as also Oleum Costinum or Oyl of bitter Costus Or else the body may be washed with the Decoction of Smallage Parietary the sharp Dock root the Seed of the bitter Vetch Orobus Lupines White Cicers Bran. Or Take Lupine meal three ounces Sulphur two ounces mingle them with Vinegar and anoynt the body therewith Or Take Litharge Sulphur Turpentine of each one ounce and half the Juyce of Mallows and Parietary of each one ounce Oyl of Cinnamom as much as you think fit and mingle them But then after the use of such like things as have been mentioned the sick Person must make use of a blood-warm Bath of sweet Water More hereof may be seen in the first Part Chap. 27. touching Scabbiness since that most of those Medicaments that Cure the Scabs and especially the dry Scabbiness they are likewise useful in the Itch. Chap. 9. Of the ill and offensive Smell ANd lastly among the Affects of the Skin we must not pass over in silence that stinking and offensive smel that is sometimes wont to breathe forth out of the external parts of the body through the Skin and to be very offensive not only to the By-standers but unto the Person himself also whosoever he be that is troubled therewith For the body of man whiles it continueth in its right state smelleth not at all neither doth it send forth any favor that may by any one be perceived For every living Creature whatever it be doth breathe forth some kind of Smel proper unto its own kind as Theophrastus teacheth us in his Book of Smels and this he proveth by experience by which we see that Dogs find out and follow their Masters foot-steps by the help they have from this smel and wild Beasts likewise do the same in seeking their Prey But yet nevertheless if any smel shal be perceived to come from any one this is a thing that is preternatural as being beyond and besides Natures Intent And as for what Plutarch writeth in the life of Alexander the Great that the body of the said Alexander sent forth a sweet and pleasant smell this is a thing very rare unless haply it come more from the Cloaths then the body But that ill and stinking smels do oftentimes proceed from Mans body is a thing wel known by frequent observation Now the places from whence the offensive smel cometh are the Mouth the Arm-pits the Privy Parts but more especially the Feet But that the Ears and the Nosethrils likewise do sometimes stink this proceedeth from the Ulcers that are in them Yet sometimes notwithstanding there exhaleth forth a stinking offensive smel even out of the whole body of him that is thus affected as for the stink of the Mouth we have already spoken thereof in Book 2. Part 1. Chap. 19. But now it is not our Intent here in the general to dispute of the Nature of smels what it is and likewise by what means the sweet or unsâ—vory very smel is generated in regard this may be known from Philosophical and Physical Discourses In this place it is sufficient that we know that this offensive smel and stink proceedeth from a superfluous humidity putrefying and exhaling such a like vapor Hircus The stinking smel of the Arm-pits is called Hircus Avicen Septima quinti Tract 3. Chap. 23. tels us That there are some who assert that the Remainders of the Seed that were superfluous in Generation and brought into this place are the cause of this stinking and offensive smel Which Opinion although that Avicen rejectech it and that by others the cause of this smel is said to be the astriction of the pores of the Skin in that place by reason of which the vapors cannot freely breathe through and exhale yet notwithstanding this constriction or shutting up of the Pores is not sufficient for if it were so then this Affect should be most familiar unto old people And this opinion albeit thus rejected by Avicen doth not in any thing seem to be absurd For we know well that this Affect is most familiar unto Virgins that are marriageable if at any time they grow hot with motion And that the Testicles and the Seed have in them a full power of imprinting such an offensive and stinking smel upon the blood we may sufficiently know it from Goats and other living Creatures that are gelded Yet nevertheless this feat smel is most especially familiar unto those that have very moist bodies because that moisture is most obnoxious unto putridness For although that all the blood do not putrefie yet notwithstanding about the Emunctories the excrementitious vapors are apt and very ready to receive the putridness The offensive smel of the privy parts in some And for the very same cause the privy parts of many yieldeth the like offensive strong smel by reason of excrementitious humors which from the Liver and the Veins are thrust forth unto the Emunctories that are seated in the Groyns from which stinking vapors do exhale Stinking Feet The Feet likewise of some have a very feat and strong smel and truly be said to stink For whereas Nature is wont to thrust forth the excrementitious humors unto these external parts the Feet being so covered and shod that the vapors exhaling from them cannot freely expire and breathe forth they then and there receive a putridness and from thence that stink is contracted And lastly but this is very rare the whole body stinketh unless
perfectly Cured albeit that the wounded person die not thereof but a Callousness being brought over it the Pipe still remaineth by which the Urine is voided forth But yet nevertheless it is not long that a man can continue to live with such a like wound and therefore we say here again as we said also before that there is a difference to be made between a wound Mortal and a wound incurable But yet notwithstanding touching al the Wounds of the bowels hitherto mentioned this is to be observed that albeit there have been observed some examples of such like wounds that have been Cured yet that this hath happened very rarely and that among these those are to be numbered touching which Averrhoes saith that in the Cure of Diseases there are somtimes Miracles wrought For when fit and proper Medicaments cannot be applied unto internal wounds but that the whole work must be committed unto Nature if in this Case Nature be not very strong and Vigorous the wounded person is very hardly Cured but for the most part an inflammation Convulsions Faintings and Swoundings and other the like Symptoms supervening the party dieth And therefore Hippocrates saith rightly in the sixth of his Aphorism Aphor. 18. that such wounds are Mortal and in his Coaca that most commonly and for the most part men die of such Wounds And therefore if upon the receiving of such a wound the sick person die within a short time after the Cause of his Death ought to be imputed unto the Wound since that much help is not to be hoped for from the Physitian as we shal also anon shew you And Lastly Hippocrates reckoneth up the Wounds of the greater Veins among those that are Mortal Wounds of the great Veins and indeed rightly But now by the word Phlebae he understandeth both the Veins and Arteries and by Pacheis he meaneth great and lying hid within which elsewhere he termeth Aimorrhous that is to say pouring forth Blood such as are the great hollow Vein and the great Artery and the great branches of these For such veins and arteries seeing that they cannot be shut close by any ligature whatsoever the blood and the spirits plentifully flowing forth of them the strength and powers of the Body are soon dejected or else the blood that is fallen forth without its own proper Vessels if it hath no passage forth but that it be still deteined in the Body it Clotteth together and putrefieth and getteth unto it self a very evil corrupt and Malignant Nature causeth a Gangreen and exciteth most grievous Symptoms and at length bringeth even death it self upon the party And indeed this danger is most grievous and formidable in the Arteries when the Blood and vital spirits being poured forth the powers of the Body are dejected and the mans life endangered neither can the Arteries be easily brought to close by Reason of their continual motion and hard substance And these are the Wounds that as Hippocrates rightly saith are Mortal Of which notwithstanding as I told you before some are simply or altogether Mortal which Prosper Farinaceus Tit. de Homicidis Quest 125. Part 3. defineth that they are such that require not the Care and advice of Physitians but are such of which the Wounded person dyeth that is by Reason of which although they be Cured by all the Art and industry of the most skilful Physician yet nevertheless the Wounded person instantly dieth thereof And others of them are not altogether Mortal and certain in their causing of death which the same Prosper Farinacius defineth to be such of which the Wounded party dieth not suddenly and of which somtimes he dieth not at all But what Wounds of the latter sort are Mortal that is of which although some are now and then cured and recover their perfect health and strength yet nevertheless this or that particular person may truly be said to have died of them will indeed plainly appear from what we said before touching the Mortal Wounds of each single and particular part And yet nevertheless this is likewise to be added that we are especially to Judg by the Event whether any such Wound be actually Mortal or not For although some strong and lusty Boor or a Man otherwise exactly found and healthful shall recover of some such wound yet Nevertheless it will not necessarily follow that therefore an old person a Child a Woman or any other that is but of a weak constitution must recover of the like wound but albeit the former of these was cured of the like wound yet this latter may necessarily die of the same But now whether or no such dangerous Wounds be Mortal in this or that particular person Nicolaus Boerius in his 323. Decision Num. 11. teacheth us how we may discover it by fix Conjectures The first whereof is the shortness of the time to wit if the sick person die very suddenly after the Wound of which space of time albeit there be very many opinions touching it yet notwithstanding he saith that the principal is this if the wounded person shall die within three daies after the wound received But yet however there are some that extend this space of time unto the fifth or even also unto the eighth day But others notwithstanding extend this term even unto the eighth month or a whole year and this seemeth unto me most probable And unto this space of time the Mosaical Law Exod. Chap. 21. seemeth to have respect The Second Conjecture is the persevering of the vomiting and feaver and other Symptoms that from the very first signifyed and threatened death And this is a right Conjecture and according to the Opinion of all Physicians yea even of Galen and Hippocrates himself For those great and mortal Wounds have their Decretory and Critical daies like as Acute Diseases have as Hippocrates tels us 2 Prorrhet in the which good or evil Symptoms are wont to happen And therefore if grievous Symptoms such as are Convulsions Vomitings sobbings Dotages Syncopes and the like which otherwhiles also are wont to presage Death in such as are wounded presently and even from the very first invade the wounded person or else appear upon him on the Critical day and after continually persevere they then signifie that they were necessarily brought upon the Party by the Wound and therefore that the Wound is altogether mortal The third Conjecture is the breadth and depth of the Wound For a Wound that is very great and dangerous in it self may yet although it be great yet not be dangerous if by it no Noble part be hurt The fourth Conjecture is the quality of the instrument with which the Wound is given and by which the person inflicting the Wound is convinced that he had a will and purpose to kil the party Wounded But this conjecture concerneth rather the Court of Justice then the Colledg of Physitians who inquire not so much after the will and intention of the person wounding as simply and
to be cured in that manner we told you of in its own proper place Touching the Inflammation Now very often there happeneth unto Wounds an Inflammation and somtimes likewise an Erysipelas And indeed an Inflammation doth most commonly if not evermore follow upon the inflicting of a Wound and more especially in the Nervous parts in regard that the afflux of Blood unto the part affected stirreth up and causeth a pain therein and moreover because that the Blood when it cannot sufficiently flow forth from thence it putrifieth and very easily exciteth an Inflammation which is prevented by a due and sufficient efflux of the Blood touching which Hippocrates thus writeth in his B. of Vlcers If there flow forth of the Wound Blood more or less according to the strength of the wounded person then both the Wound it self and those parts that are neer about it are the less troubled and affected with any Inflammation that shall follow upon the Wound And therefore if there be any cause to fear an Inflammation and if the blood hath not sufficiently flown forth then forthwith a Vein is to be opened in the opposite place and the Blood is to be evacuated according to the strength of the sick person and as he is well able to bear it Yea and moreover if there be already present an Inflammation and that the Patients strength will bear it and necessity so require Venesection and Purgation are both of them to be administred according as there shall be need If the Inflammation be excited from pain then we are to endeavour that the said pain be taken away and withal that the afflux of Humors be repressed Avicen for this use highly commendeth the Cataplasm that is made of the Pomegranate boyled in astringent Wine then bruised in a Mortar and so made up into the form of a Cataplasm There may likewise a Cataplasm be made of the meal of Barley of Sea-lentiles Mouse Ear and Oyl of Roses But if the Inflammation be not removed by these the rest of the Cure is then to be performed as we shewed you before in the first Part Chap. 5. Touching an Inflammation Of the Erysipelas If an Erysipelas follow upon the Wound this will soon appear from those Signs that we gave you in the first Part and 7. Chapter touching an Erysipelas And in what manner it is to be cured is manifestly declared by those things that are there spoken of And the truth is Hippocrates in his B. of Ulcers teacheth us that whensoever an Erysipelas shall follow upon an Ulcer that then the Body is to be purged And indeed if it be so that Choler abound lest that there should be an afflux thereof unto the Wound it will be very expedient wholly to evacuate the same And yet notwithstanding because that the Erysipelas which we cal Rosa hath its original rather from the thinnest of the Blood and that part of it that is peculiarly corrupted Sudorificks are therefore most especially useful as there we told you Hippocrates was wont to impose upon the part affected the Leaves of Woad or the Juyce thereof with Clay We may likewise apply unto the place affected Cataplasms of Barley meal and Eldern Water and other the like such as we have there mentioned to wit in the place before alleadged Of the Super-excrescent Flesh And sometimes likewise it so happeneth that the Flesh becometh Luxuriant and proud as we term it and groweth forth beyond all reason and measure which hidereth the production of the Cicatrice and its covering over of the Wound or at least it causeth the same to be unfightly and deformed But this happeneth through the unskilfulness or want of care in the Physitian who administred Medicaments that were not sufficiently drying And therefore what Flesh we finde to be superfluous we must take it away that so the Wound may be shut up with a Cicatrice But now this is the work of the Physitian who is to consume the superfluous Flesh with Medicaments that are sufficiently strong in their drying cleansing and if need so require somwhat Corroding likewise But now what those Medicaments are with which this may be done we have told you before in the 2. Part and 7. Chapt. whither we refer you Of all which Medicaments there mentioned the most useful and principal is the Green Water there spoken of which both consumeth the superfluous flesh and likewise bringeth the Cicatrice over the Wound when it is cured Of the Haemorrhage There happen also many Symptoms unto Wounds which partly deject the strength of the Patient and partly render the Curing of the Wound more difficult then otherwise it would have been And first of all there oftentimes happeneth indeed an extraordinary great Haemorrhage and profusion of the Blood which doth not only deject the strength and Spirits depriving the Patient oftentimes of his Life but it likewise very much hindereth the Cure For so long as the Flux of Blood lasteth there can nothing at all be done in the Cure Now that said Haemorrhage happeneth upon the wounding of the greater Veins as also the Arteries not only the greater of them but the mean and middle sort of these Arteries But touching this Symptom we have already spoken above in the 14. Chapter where you may see further Of pain with the VVound And oftentimes likewise there is an extraordinary vehement pain following and accompanying the Wound For although there be indeed hardly any Wound without pain yet nevertheless very usually this pain is tollerable and such as the Patient can wel bear But somtimes it is vehement and altogether intollerable which happeneth more especially when the Nerves and the Nervous parts are hurt and Wounded and an extream vehement pain arising immediatly upon the inflicting of the Wound is a sure and certain Sign and token that either a Nerve or a Nervous part is wounded The Cause Now this pain is excited in Wounds somtimes by reason of Errors committed by the Patient in the Course of his Dyet whiles he eateth all manner of bad and corrupt food as Cabbage and Cole-worts salt Fish Swines flesh or the like whiles he exposeth the wounded part unto the cold Air and moveth it overmuch by exercise And somtimes also this pain happeneth by the Carelesness of the Chirurgeon who administreth Medicaments that are overhot and too sharp hindeth the part too hard and streight placeth â— not aright thrusteth into the Wound Tents over long or thick leaveth the Pus over long in the Wound and suffereth some piece of bone to prick and molest the part that lieth next unto it And somtimes also without any of these Causes a pain may be excited by an internal afflux of the Humors and this pain oftentimes invadeth the wounded person suddenly and with a certain unwonted coldness and Chilness and this is oftentimes a very shrewd sign of some great Inflammation instantly to follow or even of a Gangrene very nigh at hand and this especially if together with the pricking
Eczesma 2. Elcydrion sive Papilla 3. Sycon that is a Fig or pushes in the head resembling it 4. Exanthema that is an Ulcerous blowing out like a flower 5. Ganglion 6. Hydrocephalus 7. Syriasis 8. Phrenitis 9. Lethargus 10. Typhomania seu agrypnon coma 11. Catochus Pauli 12. Catalepsis seu Catoche 13. Carus 14. Apoplexia 15. Rhia alsabian 16. Sibare 17 Fatera 18. Sekakilos 19. Testudo 20. Talpa 21. Topinaria 22. Lactumen 23. Cornu 24. Alopecia 25. Ophiasis 26. Pityriasis 27. Phthiriasis Those properly belonging to the Eyes and the parts thereof Tumors of the Eyes and their parts 63. sixty three which in page 351. he reckons up in this order following 28. Proptosis Galeni sive ecpiesmos Pauli 29. Taraxis 30. Ophthalmia 31. Epiphora introductorii 32. Chemosis 33. Xerophthalmia 34. Sclerophthalmia 35. Scirrhophthalmia 36. Phlyctaena 37. Bothrion 38. Coeloma 39. Argemon 40. Epicauma 41. Encauma 42. Myocephalos 43. Melon 44. Clavus Pauli et Aetii 45. Clavus introductorii Celsi 46. Hypopyon 47. Onyx that is Vnguis a Nail 48. Hyposphagma 49. Achlys Aetii 50. Nephielion Aetii 51. Vla or Nephelion 52. Leucoma 53. Sebel 54. Bothor Avicennae 55. Hymene panastasis 56. Nyctalopia 57. Anthracâ—sis 58. Carcinoma 59. Synchysis 60. Mydriasis 61. Proptosis Pauli 62. Ptylosis 63. Madarosis or Milphosis 64. Pladarotes 65. Emphyspma 66 Symphysis or Ancylosis 67. Eutropion 68. Laâ— ophthalmos 69. Trachoma 70. Sycosis 71. Tylosis 72. Dasyma 73. Pachytes 74. Barytes 75. Hydatis 76 Psocophthaâ—mia 77 Truhe 78. Thalazion 79. Porosis 80. Litâ—iasis 81. Alanâ—isac 82. Sude Avicennae 83. â—arcosis 84. Lupia 85. Mydesis 86. Pustula Abenzoaâ—is 87. Scleriasis 88. Anchilops 89. Aegylops 90. Epinyctis Plinii And 〈◊〉 these he mentions many more in other parts Tumors in all other parts of the Body 97. to the number of ninety seven and in this following order he sets them down 91. Auritus 92. Parotis 93. Pherea 94. Ozaena 95. Sarcoma 96. Theluâ— Albuc 97. Alharbian Avicennae 98. Chaisum Arabum 99. Haemorrhoides Arabum 100 Batrachos 101. Glossomegethos 102. Ancyloglosson 103. Aphtha 104. Cynanche 105. Paracynanche 106. Synanche 107 Parasynanche 108. Gongrona 109 Folium 110 Bronchocele 111 Alhadal 112 Dionysisci 113. Hypopion 114 Jonthi or Vari 115 Montagra 116 Ephelis 117 Ignis sylvaticus 118 Noli me tangere 119 Buttizaga 120 Gutta rosacea 121 Sparganesis 122. Chondriosis 123 Trichiasis 124 Gynaecomaston 125 Pleuritis 126 Peripneumonia 127 Phtoe 128 Althahalop 129 Napta 130 Cyphosis or Cyrtosis hybosis 131 Lordosis 132 Scoliasis 133 Coeliacus 134 Aurys Rasis 135 Colica 136 Hâ—os 137 Condylomata 138 Haemorrhoides 139 Marisca 140 Hepaticus 141 Cachexia 142 Altherel Bellunensis 143 Thelegi 144 Altherbel Bellunensis 145 Splenicus Aureliani 146 Nephritis 147 Lithiasis 148 Satyriasmus Pauli 149 Cercosis 150 Mola 151 Nymphomegethos 152 Kion Hippocratis 153 Seliroma Pauli 154 Arthritis 155 Podagra 156 Cheiragra 157 Ischias 158 Lupia Guidonis 159 Tophi 160 Cornua Avicen 161 Ancylosis or Ancyla 162 Paâ—onychia 163 Pterigion Celsi 164 Condya 165 Perniones 166 Gemursa Plinii 167 Dentes muris Bellunensis 168 Alliathan 169 Lupus 170 Dactilia Haliab 171 Malum moriuum 172 Terminthos 173 Emphysema 174. Phlyctaena 175 Turmusios Avicen 176 Impeâ—go 177 Essere 178 Palmos 179 Clavus 180 Calli. 181 Aegritudo bovina Abenz Albuc 181 Dracontium 183 Syrenes or Pedicelli Guâ—don Argelatae 184 Variolae 185 Morbilli 186 Rubeola 187 Crystalli 188 Exanthemata 189 Ecthymata Fernel 190 Hidroa or Sudamina 191 Epinyctis Romanorum 192 Bothon lenes 193 Ganglia 194 Seps Hippocr 195 Spina ventosa 196 Bubasticon Vlcus 197 Hypersarcon 198 Cacoethes 199 Sepedon 200 Nome 201 Therioma 202 Herpes Esthiamenos Celsi 203 Herpes ecthiomenos Avicen 204 Thymion Celsi 205 Ignis sacer Celsi 206 Cerion Pauli 207 Paratrimmata 208 Aposirmata 209 Zerma 210 Rancula 211. Spina 212 Morsus Diaboli 213 Patursa that is Morbus Gallicus 214 Scopuli 215 Tincosati 216 Pinitae 217 Spili 218 Tusius Aviceâ—â— 219 Eparma Hippoc. 220 Rosboth 221 Cunus Rasis 222 Albothir Albucasis 223 Nakir Albuc 224 Alchalan Abenz 225. Arcella Abenz 226 Rosulae sataritiae So that the number of all the Tumors recited by Johannes Philippus Ingrassias amounts unto two hundred twenty six But that Entities should be multiplied in this manner without any cause is altogether unfitting For as al the affects which are here reckoned up under the name of Tumors are not properly to be accounted Tumors besides that one and the same Tumor is somtimes repeated under different names So again Ingrassias having not at this time compleated the remaining Sections of his Works concerning Tumors it is not sufficiently apparent what Tumors he would have us to understand under some of these names Now for the truth of this that I may give you an instance or two of what hath been said he reckons up among Tumors Sinus and Fistula Vlcus Chironium and divers other Ulcers But before or since Ingrassias who hath there ever been that hath taken the liberty or made so bold to enumerate among the Tumors that are properly so called such as are these following viz. Lethargus Typhomania Catochus Catalepsis Carus Apoplexia Lordosis Coeliaca affectio Colica Affectus hepaticus Splenicus and other such like Affects which relate either to Symptoms or the kinds of other Diseases rather than unto Tumors And in very truth many of the Tumors wherewith this Catalogue is stuft are not peculiar kinds of Tumors but only differences of their species according to the parts affected Tumors their Differences Now therefore we conceive that there are two main Differences especially to be heeded in Tumors one whereof ariseth from the variety of Causes and the other is by reason of the parts affected We have said before that the conteining cause of a tumor is threefold a Humor a Wind and a solid Substance Again the humors are various much different to wit Blood Phlegm Melancholy a black humor a waterish and wheyish humor and divers other thin excrements as also mixt humors and matter into which other humors degenerate and likewise malignant humors From the Blood there is caused an extraordinary Corpulency which the Greeks call Polysarcia and an Inflammation Their Cause containing There are likewise that refer a Gangrene a Sphacelus unto an Inflammation in regard that an Inflammation somtimes degenerates into them But because that a Gangrene and Sphacelus do very often proceed from other causes without an Inflammation and have not alwaies a Tumor to accompany them and are of neerer alliance unto Ulcers very usually degenerating into them we wil therefore treat further of them anon when we come to speak of Ulcers But with more right it is that unto an Inflammation we refer an Erysipelas or Rosa as it is commonly termed Bubo Furunculus Phyma Phygethlon Parotis Carbunculus Paronychia Perniâ—nes Ecchymosis as afterward from the special Explication of these Affects wil
parts are as I may so say embrued with blood yet notwithstanding there is a certain order observed to wit that some of the parts should sooner receive the fluxion and others of them not til afterward until that at length all of them come to be replenished and distended by the humor Now this kind of order wholly depends upon the natural distribution of the greater Vessels conteining the blood For whereas the Veins and Arteries when they first of all make their entrance into the aforesaid Vessels are evermore the larger and by how much the deeper they are distributed thereinto so much the less they are all this while there ariseth no Inflammation unless it so chance that the blood be emptied forth into those smallest Veins and again happen to fall out of them And this that hath been said manifestly appears unto those that by an exact and accurate inspection take a right view of those very little and almost imperceptible Veins that are branched forth and extended unto that Tunicle of the Eye which Oculists usually call Adnate or Conjunctive For these indeed do evermore convey blood unto the Eye for its nourishment and yet notwithstanding whilest that the Eye is free from distemper they are so exceeding smal that they can hardly be discern'd by the sharpest sighted Eye But then so soon as the Eye is inflamed those slender Veins are preternaturally replenished with blood then they shew themselves and become very conspicuous And it is most agreeable to truth that thus it should be also in al other Inflammations whatsoever they be But as yet there is no Inflammation present albeit the lesser Veins are even filled up with blood until that at length by and thorow them the blood be derived into the remaining substance of the parts which may be done two waies For in the first place the blood is emptied forth by those very smal and most inconsiderable orifices of the Veins by which the Veins do as it were gape open themselves into the surrounding substance of the part that so thereby the blood may through them the more easily drop forth for nutrition or nourishment Moreover likewise it strains and sweats through by the Tunicles of the Veins for even the Tunicles of the Veins are in like manner so framed by nature that they are not without their pores through which if not the blood it self yet certainly the ferosity or wheyiness thereof and its thinner part is exâ—udated or sweated forth by a kind of percolation From what hath been hitherunto spoken the distinction of the conjunct cause from the cause meerly antecedent in an Inflammation is sufficiently apparent For the blood which we have asserted to be the cause of a Phlegmone doth in a double respect take upon it self the virtue and Nature of a cause For either it is the next conteining and conjunct cause of which we have hitherto discoursed to wit as it hath already flown into the part and is irremovably impacted therein so far forth that it actually elevates that same part into a Tumor or else it is the antecedent foregoing cause to wit The antecedent cause of an Inflammation as by reason of its abounding in the body it hath a power of slowing into and by its influx of lifting up the part into a Tumor or Swelling The which antecedent Cause in an Inflammation like as also in other Tumors fals again under a twofold consideration to wit either in regard of the Affect simply considered as it is to follow upon this cause which it hath a power to excite although as yet it hath no being in the body And so a Plethory which is an extream and overgreat fulness of good and laudable blood is very frequently present in the body albeit an Inflammation doth not instantly ensue thereupon Or else secondly it is considerable as preceding and foregoing the affect that already hath a being and is already actually existent in the Body to wit when as the Blood now floweth to the exciting and augmenting of the Tumor Which to speak truth is more rightly stiled the antecedent cause then was the former since that this latter hath respect unto an effect already present but the former relates only unto an affect which hapneth in the future time But this antecedent cause that it may flow together unto the place affected it is thereunto moved and stirred up by other means whilst that it is either transmitted from some where else or else attracted by the part it self for those very causes we have hitherto been treating of and explaining But now for those Causes which we commonly term Procatartick The remote Causes more remote and primitive they are such as either conduce to the breeding of a copious and a plentiful blood as do al meats of good and much juyce an easie and idle kind of life and other such like requisites Or else they are such as render the blood more acrimonious and sharp as do all things that cause heat al acid and tart aliments wrath watchings stirrings and exercises in the extreme or else such as excite and stir up the blood to move unto the part affected as doth the overgreat heat of the part pain proceeding from a wound from a fall from contusion or beating from a fracture from disjoyntures and the like causes or else the weakness and imbecillity of the part affected receiving compared and considered in reference to the vigour and strength of those other parts which transmit the abundant store of hot blood unto the aggrieved part Notwithstanding an Inflammation never happeneth to be generated by a leisurely and gradual storing up of blood but it is evermore bred by a sudden and thronging affluence and influx of the said blood For although it may so chance that some kind of Humor may sensibly and by degrees be collected in some one part which being heaped up as aforesaid may afterward begin to excite a certain kind of pain in the part yet notwithstanding al this an Inflammation is never produced until such time as the pain gives cause sufficient that a more plenteous store of blood should forthwith and very easily make its approach Notwithstanding we are to take notice That although the Blood be the containing and antecedent Cause of an Inflammation yet notwithstanding we say that a Cacochymy or a depraved ill digestion and more especially sharp and cholerick humors are the prime and principal cause that the blood be moved unto the part affected in those Inflammations which are excited without any apparent cause as Wounds Contusions and such like For so it is That when Nature is twinged and pulled by such like Humors and yet notwithstanding is unable altogether to expel them out of the body to the end that she may free the principal parts from the danger impending by reason of them she assays to thrust them forth unto the external and less principal parts the which when it is not able to accomplish
the beginning of the distemper it ought to be attempted from a far off but afterwards from the affected parts themselves Now what kind of remoteness and what sort of longitude he understands is explained in his fifth of the Method of Physick Chap. 3. A Revulsion saith he ought alwaies to be carried downward in those affects which are upward and upward evermore in those that are below and moreover also the Revulsion ought to be made from the right side unto those on the left and again in like manner from those unto these and semblably from those places that are internal unto such as are outwardly scituate and on the contrary from these unto those For when as the main scope of Revulsion is not to evacuate those humors which are already conteined in the part affected but those rather that are flowing thereunto and seeing it respects rather the part sending the blood than that which receives it from these premises it necessarily follows that questionless this is required in every revulsion to wit that it should by all means procure a motion contrary unto that which flows that so it may not any longer be moved unto the part affected and for this cause the revulsion must not be ordain'd either from the grieved part or from that next unto it but rather from the opposite yea and so far forth as possible it may be from the places most remote from the affected part And hence also it is that every opposition doth not constitute a contrariety neither hath every kind of opposition any place in a Revulsion but those oppositions alone which Galen in the before alleadged third Chapter of the fifth Book of his Method of Physick recites to wit upward and downward from the right side parts unto the left from the places that are within unto those that are external and so on the contrary Yet if there be only but a very smal inconsiderable distance we cannot safely nor conveniently draw back from the parts more inward to those more externally scituate but then only when the distance is greater But that opposition which is from before and behind or according to the fore parts and hinder parts hath no place in this kind of Revulsion which is so called singly and absolutely For neither if any affect shal chance to be in the backward part of the Head are the Forehead Veins forthwith to be opened by way of revulsion since that may not be done without manifest danger during the continuance of the Plethory and flowing of the humors But enough hath been said of Revulsion in the fifth Book of Institutions Part 2. Sect. 1. Chap. 18. But that we may in few words contract whatsoever hath there more at large been spoken Revulsion twofold and whatever else may be said upon this subject it is in the first place to be taken notice of that Revulsion is twofold one which is accomplished together with the evacuation of the humor such as is that which is effected by Blood-letting and Cupping-Glasses with Scarification the other which is wrought without the evacuation of the humor such as is that which is performed by Frictions or Rubbings Ligatures and Cupping-Glasses without Scarification This latter is never to be practised but when the Revulsion is to be made unto the parts most remote since that if it be instituted in the neer adjacent parts then the humor which is only stirred and not totally evacuated may without any difficulty or resistance rush upon the affected part And it is very rare and scarcely ever known that this kind of revulsion hath place or any thing to do in an Inflammation which requires a manifest sensible and suddain evacuation of the blood Furthermore Revulsion by opening of a Vein as for what concerns Revulsion which is effected by opening a Vein this one thing at least is to be observed which if it be wel heeded many intricate controversies touching the thing now in question may be determined to wit that the utmost endeavor must be used that a contrary motion may be procured unto the blood and that as much as possibly may be drawn back unto that Fountain from whence it flows And since that the Liver is the Fountain and Sourse of the blood and that the greatest store of the blood is conteined in the Vena Cava or great hollow Vein nigh about the Liver we must do our utmost that the blood which flows into the inflamed part may be drawn back towards its Spring-head yea also if it be possible unto the opposite part yet notwithstanding so that the blood which flows may be retracted and drawn back And therfore in every Revulsion this at least is to be wrought that the blood may obtain such a motion as that by it the part affected may not be injured by its immoderate conflux but that it may rather be again recalled from the diseased part But how this may be effected in every part here to declare unto you would be a business too tedious besides we have already elsewhere spoken to this very point in our treating of particular affects Revulsion when to be ordained after what manner And by what hath been said as I conjecture it is sufficiently apparent how and in what manner a revulsion is to be ordained in case of an Inflammation so that there wil not be any great need that we should add much as touching the right and due administration thereof For whereas revulsion is then only suitable and proper unto the Humors when they flow and unto them alone and not unto those which have done flowing and have seated themselves in the part affected it is hence manifest that it ought to be instituted and appointed in the very first rise of the distemper Notwithstanding this is not so to be understood as if in the first appearing of an Inflammation we were instantly to put revulsion in practice for if either there be no great store of blood or if its rushing in upon the part be not over violent and impetuous Medicaments that drive back and derive will be sufficient But then only is Revulsion to be put in practice when there is great plenty of blood and a more than usual violent and forcible rushing thereof unto the part affected and according to the greater or less proportion of this abundant blood and the more or less vehemency of its motion so answerably ought the Remedies and Medicaments that are prescribed for Revulsories or drawers back to be ordained so much the more or less strong and forcible But now that Revulsion which is made with an effusion or emptying forth of the matter must needs be greater than that which is made without it But amongst all the Remedies which we term Revulsories or drawers back the most prevalent and efficacious is the opening of a Vein which said Venesection doth more effectually or less strongly draw back accordingly as the Veins that are opened be greater or less The greater
and apt to flow Wherefore that we may rightly understand that which is on all hands taken from granted to wit that during the consistency or continuance of the Inflammation derivation ought to be administred this is not to be taken as meant either of the state or as we cal it the perfection of the distemper or of its declination but rather of the latter part of its beginning In derivation what to be observed Now in Derivation that community and correspondence that is between the Veins and the part affected of which we have formerly made mention is especially to be observed For if the blood that is in the Veins of the affected part ought to be drawn thence unto the neighboring parts by derivation then in this case we must evermore make choyce of such a Vein to effect it by as hath the neerest commerce and vicinity with the part affected the which if it be opened brings along with it an apparent and admirable benefit But now for the measure and proportion that we ought so heedfully to take notice of observe in letting blood by way of Derivation Hippocrates informs us in Book 7. of the Course of Diet in acute Diseases chap. 10. The blood saith he must be drawn away so far forth and so long until it flow forth more red and much yellower or that instead of a ruddy color it appear to be of a livid or leaden-like color For as Galen there tels us whatsoever blood is contained in a Phlegmone that same will be changed in its color through the abundance of heat but the rest will all of it continue alike in all parts of the body And for this cause that blood which is contained in that side that is afflicted and inflamed with a Phlegmone must needs be much more red and ruddy than that which is dispersed and diffused throughout the whol body especially if the body be pituitous or Phlegmy Now if the blood that is diffused into the whol body appear to be al of it of a more ruddy color than ordinary without doubt then that which accompanieth the Phlegmone boyled and burnt as it is must needs be changed into a black hiew And from hence it is that a change in the color denotes and signifies a translation of the blood from out of the part affected which said change notwithstanding is not evermore to be expected if strength be wanting in the Patient And after such like waies as these may the Humors that flowing forth together unto a part generate there a Phlegmone be removed from the aggrieved part Among the which before mentioned notwithstanding those Medicaments that drive back and derive very much conduce like as the other for the removal of the humor that flows amain into the part affected For Repellers although their principal scope be to repress the humor that flows in and is as yet contained within the Veins of the part yet notwithstanding they have a power also to drive and thrust back again into the Veins to cast out of the part those humors likewise that are newly fallen forth without those Veins and as yet not it removably fixed in the place whither they are fallen For neither is it a thing impossible that the Humors that are fallen out of the Veins should again retire back into them even as many sorts of Tumors in the skin evidence unto us the truth hereof which now and then in a cold season suddenly vanish away and disappear And so likewise derivation albeit it hardly cal back those Humors that are fallen forth without the Veins yet notwithstanding as for the blood which fluctuates in the Veins of the inflamed part it hath a power sufficient to draw it unto the neighboring parts and by them to evacuate it Notwithstanding Evacuation since that by the alone use of Repellers and Derivers al the whol matter is seldom evacuated out of the part inflamed but that after the use of them for the most part somwhat is left remaining behind this ought in another manner and by other means to be evacuated Now this evacuation is accomplished after a twofold manner either insensibly and by an imperciptible transpiration which the Grecians cal adelos diapnoe or else sensibly and manifestly The matter is evacuated insensibly by Diaphoreticks or Sweaters as likewise by those that we term Digestive Discussive and resolving Medicaments The sensible evacuation is performed by scarification and the opening of the part after suppuration or as we commonly term it maturation of the peccant humor We will therefore in the first place treat of the former manner of evacuation and declare our opinion touching discussive Remedies But now Discussion since that resolution or discussion is nothing else but an evacuation of the humor by an insensible transpiration it wil from hence easily be made to appear that what is to be discussed ought to be thin or fluxile and not over clammy and thick neither the skin it self too much shut up and condensed For if the matter be over thick it cannot then be easily resolved into vapors but if the skin be too thick and compact like as also if the matter stick in a place over deep when all or any of these happen then the matter causing the distemper finds not easily any way for its passage forth neither can any Remedies but what are very forcible penetrate unto the place affected Discussives what they are for their quality Moreover since that al digestive Medicaments are hot in their operation as by and by we shal further shew you they are therefore to be administred not over hastily in the very beginning of the Inflammation but then we ought rather to make use of Repellers for the reasons before mentioned But the Inflammation approaching now nigh unto or if ye will while it is yet in its passage towards its augmentation some kind of digesting Medicaments ought to be mingled with the Repellers and so al along the quantity of the Discussives ought evermore to be encreased until at length in the declination they alone come to be administred Now the truth is al Digestives or Diaphoreticks are hot for the Humor cannot be resolved attenuated and converted into vapors but only by heat But of such things as are hot there is a very great difference for some of them do only rarefie or open the orifices of the Vessels other of them cut the Humors and a third sort there is that attracts and draws them and last of all there are others that are of a burning quality Now the Diaphoretick Medicaments differ from them all and have in them this proper and peculiar faculty to resolve the Humors and to convert them into vapors Which said quality of theirs may not so easily be described by their Causes but it is rather discovered by the experience that we have of their effects so that what cannot be defined by reason that same is supplied by experience and use But
tels us of another far more easie and compendious course that he himself had found out and discovered in curing Apostems newly opened whereby on the third or on the fourth day at the furthest all the aforesaid Cavity of Apostems might be remedied and perfectly cured by drawing together what was divided which operation we cal commission and conglutination of the Impostume so that nothing should be left gaping beside the opening or incision place which was made by Art to the end that thereby the Pus might flow out and be pressed forth and that al this should be effected without any the least danger to the sick party without much if any pains and labor or any other difficulty Now his way and method of Curing was as followeth If the Tumor or Apostem be great then saith he in the first place let it be opened in the best manner that may be so that the little finger may be put into the orifice and that thereby al the Pus that is contained within the Impostume may be permitted to flow forth and may likewise be thence expelled by a gentle compression of the place it self The Pus being once expelled and evacuated let the mouth of the Sinus be stopt with a Tent and then an artificial Pillow or Cushion being laid and fastened down thereon let it so remain without removal until the next day following The day following the Ligature being loosened let the Ulcer be purified and carefully cleansed from al the Pus if haply there be any left remaining underneath After this is done let a Pipe or smal Cane of Lead be put into the orifice the which let it be as big and large as is the Orifice it self and let it reach even unto the Cavity or hollow place but let it not by any means be forced any further Upon this let the Basilick Emplaster spread upon a Linen Cloth be imposed in the which also the pipe may be contained that it fal not forth yet nevertheless leave a hole at the very Orifice of the Leaden Pipe or Cane Afterwards on either side of the Cavity let there be put triangular Pillows or Cushions of which before on either side one so that al the hollow space may be filled up with either Pillow c. But let the Orifice of the Sinus in which is the Leaden Pipe be left free and open neither let it be stopt up by the aforesaid Pillow nor any waies obstructed by the Ligature or binding that so al the Pus that lieth underneath may be throughly purged out afterward let the place covered by the Pillows be rolled about with a Swathband so that it may be without the least pain and let it be so ordered that the Ligature may begin at or from the bottom and tend toward the orifice that so by this means al the Pus or filth that is within may be forced toward the Orifice and through it may be pressed forth The Sinus thus bound about is to be left in this manner until the day following on which the Ligature being loosened we ought by making strict enquiry to find out how much of the Cavity remains that so we may be throughly certified Whether or no the aforesaid Pillows or Cushions did touch upon the places For al those places which were subjected by the Pillows c. wil al of them be found conglutinated and fast closed together The which when we have discovered the Pillows are again to be tied and fastened after the same fashion as they lay before and so they are to continue until the next day But now if so be that any of the Humor or of the Pus seems to be left in any place this as before is to be pressed forth with the Pillows fastened by the Swathband together with which the gaping place doth coalesce and joyn close together In this manner so soon as the parts are closed together let the Pillows be removed and then let there be imposed upon the Ulcer a Linen cloth spread over with the Authors Leonine Emplaster or such other like Plaister as suppose the Emplaster Diapalma and you may not forget to wipe and cleanse it six or eight times every day But yet notwithstanding as touching this way and manner of curing the Sinus and Cavities it is first to be taken notice of that this same doth succeed most happily in Apozems newly opened and in them only for as for an old Sinus where all is not wel within and which almost declines unto callous Ulcers and Fistula's the former way and manner of curing it is far better and safer Moreover this is likewise to be observed that we ought wel to look whether or no there remain any relicks of the indigested matter spread thorow-out the part which easily comes to be known by some apparent Tumor or Swelling as also by its redness of colour For otherwise and as long as any thing preternatural sticks in the part agglutination as we term it or closing up of the Orifice is not to be expected neither is it to be so much as hoped for And therefore be sure that the Pus it self be likewise cleansed and purged in the best manner that possibly you can Thirdly This also is to be heeded to wit whether or no the place may conveniently enough be rolled about with Swath-bands and likewise whether the aforementioned Pillows or Cushions be streightly fastened and tied down close enough that so they may both compress and keep down the severed and disunited parts and also press forth the Pus or filthy snot-like matter For if so be that the Swath-bands gape and that the Pillows press not down the part as they ought then neither is there any Pus pressed forth nor doth the part coalesce and meet together Chap. 7. Of the Tumor Erysipelas or Rosa THat Tumor which the Greeke cal Erysipelas but we here of this Country commonly Rosa from its rosie color is altogether to be referred unto and so to be accounted in the number of the Tumors that take their original from the Blood All the Latines Celsus only excepted who retains the name Erysipelas term it Ignis Sacer we in English call it St. Anthonies fire or this Ignis Sacer the Poet Lucretius makes mention in his sixth Book The Body all at once with Vlcers brand grows red As 't is when Ignis Sacer hath the whol ore-spread This Tumor is most an end by Physitians ranked among the Cholerick But yet there is ground and cause enough of doubting from what humor it derives its beginning and Pedigree For Galen himself seems now and then to stagger and not alwaies to stand to what he had spoken concerning it For in his second Book to Glauco and first Chapter he expresly writes that the most thin and hot Blood or Choler together with Blood to wit when both of them are hotter than is behooful is the Cause of an exquisite Erysipelas and there he determines that meet pure Choler
is not the original efficient cause of this said Tumor but rather of that which we usually call Herpes And in his Chap. 9. concerning Tumors he asserts that Herpes is bred or caused when a cholerick fluxion being indeed purely and exactly such happens to be excited and to exulcerate the Skin but that when this said cholerick flux is mingled with a waterish matter and with blood so is less sharp and when it rather swels up the part into a Tumor then exulcerates it that then an Erysipelas is excited But contrariwise in his Book of black Choler Chap. 5. in his fourteenth Book of the Method of Physick Chap. 1 2 3. and B. 17. Chap. 2. in his Book of the Differences of Feavers Chap. 5. and in his Book of the way of curing by Blood-letting Chap. 8. and in divers other places asserts that Choler is the cause of this Tumor which latter opinion of Galen most of our Physitians follow But truly if we lay aside the Authorities and Opinions of the Ancients and look wel into the thing it self and if we confer the name of an Erysipelas upon that Tumor that is so well and commonly known unto our Country-men and lastly if we take good notice of those things that dayly befall the sick Persons in a Disease so well known we shall then without any scruple judg the Opinion of Galen which he propounds unto Glauco in his second Book and Chap. 1. and in his Book of Tumors Chap. 9 to be by far the more true and probable For the very colour it self of the part affected being altogether rosie instructs us that Blood rather than Choler is the cause of this Tumor And although this kind of Tumor doth now and then from red or ruddy become yellowish yet notwithstanding this is not altogether true of every Erysipelas but only of some one certain species and difference thereof Moreover the humor that excites and causeth this Tumor is not altogether so sharp and tart as is Choler and for this cause doth neither exulcerate nor produce extream heat or over vehement pain Notwithstanding the Blood that excites this Tumor is the thinnest and most intensely hot and it is vulgarly said to be bilious or cholerick the same that Galen also tels us in his second Book to Glauco Chap. 1. where he writes that Choler alone when it lieth hid and secret and consists in some one member doth excite and cause the Tumor Herpes But then if so be that the fluxion shall be mingled and consist of blood and yellow choler being both of them hotter than is meet or else from the blood in this manner waxing hot and being according to its substance most thin we then call it an Erysipelas For albeit that Galen in very many other places asserts an Erysipelas to proceed from Choler yet not withstanding what he means and intends by Choler he hath sufficiently declared in the place before alleadged And if we consult experience and those accidents that betide the sick Parties we shall then find that he could not intend any thing but that Choler which they term natural and alimentary or nourishing that is to say the hottest and thinnest part of the blood but such as is now grown extreamly hot therefore the neerest that may be to Choler But now whatsoever kind of Choler we assign to be the cause of this Tumor whether yellow or pale or like the rust of Brass or Leek-coloured they wil not any of them agree with those things that happen in this Tumor Furthermore this humor hath conjoyned with it a depraved quality and a peculiar sort of corruption and before such time as it breaks forth it exciteth and causeth exceeding great streights not much unlike to those that the Plague upon the first invasion is wont to produce and therefore the same kind of Alexipharmaca or counterpoysons that we make use of in the Pestilence are here likewise to be administred for the expulsion thereof Notwithstanding the words of Galen and of other Authors that affirm the original of this Tumor to spring from yellow Choler may be drawn to a better sence I mean that they may be more rightly interpreted if we say that by Choler is to be understood the natural part of the blood which is more thin and hot and which is very commonly called Choler but it were more fitly and properly named a bilious or cholerick blood the which so soon as it begins to wax intensly hot and to boyl it then excites this kind of Tumor And very frequently there is also herewithal mingled a certain portion of a most subtile thin and intensly hot whey the which if thou hast a mind and art pleased to cal it a bilious cholerick whey I wil not gainsay or oppose thee and then there is bred an exulcerated Erysipelas yet only superficially like as oftentimes it is wont to happen in the Face when there arise and appear little bladders ful of a waterish humor and then the Skarf-skin alone is affected and parts assunder But if together with it the Skin it self shal be exulcerated which ever and anon chanceth in the Thighs then we may conclude that adust humors are therewith mingled and this kind of Erysipelas is said to be not pure or if you will impure But of this Tumor enough hath been spoken in the second Book of Feavers Chap. 16. which here we judg it not fit to repeat in regard that there the Reader may by perusal be fully acquainted with what hath been written I wil only repeat this that the first rise of this affect is from a Feaver or move plainly that the affect is primarily and originally a Feaver For neither doth an Erysipelas or Rosa invade the part but with a Feaver which oftentimes a day or two before it breaks forth is wont exceedingly to afflict and excruciate the sick Person But this Feaver is critically determined as we wont to express it and the Patient freed therefrom by means of this Tumor and thereupon it is that oftentimes a pain or some kind of swelling is perceived in the Glandules under the Arm-pits or else in the Groyns until that at length Nature shall have driven forth the matter unto some extream part of the Body for then the Feaver is wont to cease albeit the Tumor is wont to stick and continue in the part affected for a certain space after Touching the Cure this likewise is to be observed like as it hath been more at large declared in the place before alleadged that it ought to be altogether perfected and compleated and we must use the utmost of our endeavor that the humor the conteining cause thereof may be called forth and not retained therein since that by the deteining thereof greater evils are wont to be introduced and made way for which may sufficiently appear even by the example of that Country-man or Peasant mentioned by Gulielmus Fabricius in his first Century Observ 82. who having
with and therupon is by the most reckoned up and in order placed next after an Inflammation as a Tumor that hath its original from Blood over hot burnt and corrupted But now this same Tumor hath divers Names or Appellations By the Grecians it is termed Anthrax by the Latines Carbo and Carbunculus Avicen cals it Pruna and Ignis Perficus or the Persian fire By which several words names although some there be who conceive that several and different Tumors are signified and thereby to be understood and thereupon have treated of Pruna and Ignis Perficus in peculiar and distinct Chapters and likewise have handled the Carbuncle and Anthrax as distinct from them and also as differing each from the other yet notwithstanding the very Truth is that by all those aforesaid appellations one only kind of Tumor is signified for that which with the Greeks is Anthrax with the Latines is Carbunculus a Carbuncle or Fire-coal Unless any one will make this distinction out of Avicen that what beginneth without pustules and humidity is a Carbuncle or Pruna but that which beginneth with pustules and bladders and that likewise hath a moisture flowing out of it this may be called Ignis Perficus Now this Swelling is called by this name in regard that it hath over it a certain Crustiness that is black like a Coal for which cause it is also termed Pruna because the Flesh is black and as it were burnt with a Coal and moreover it is said to be a Fire in regard that the parts are burnt as by a Fire But in truth that which Celsus and Pliny have left written touching a Carbuncle seems yet scarcely in al things to answer to a Carbuncle in general but only to some one species thereof and haply unto a kind therof that is Epidemical and so a new Disease For Celsus in his fifth Book Chap. 28 thus writeth From those that befall extrinsecally we must now come unto such things as are internally bred some one part or other of their Bodies being corrupted Among which there is none worse than a Carbuncle of this Carbuncle there are these Notes and Marks there is a certain redness and upon it there stand and hang out but not very far certain Pushes or Pustules especially such as are black and somtimes black and blewish or Lead-color'd or Pale In these there seems to be a rottenness and filth beneath the colour is black the Body it self is dry and more hard than it ought to be About the which said Carbuncle there is as it were a Crust and this is surrounded by an Inflammation neither can the Skin in that place be possibly lift up but it is as it were fixed and close fastned unto the Flesh underneath it The sick Person is extream sleepy and somtimes there ariseth a certain kind of horror or else a Feaver or both And this Evil creepeth along there being drawn out as it were certain roots somtimes more speedily and somtimes more slowly and likewise above when it first proceedeth forth it looketh of a whitish colour and then instantly it becometh Lead-coloured and about it there arise little Pushes or Pustules And if it happen to light upon the part neer the Stomack and the Jaws it then oftentimes suddenly stoppeth the Breath thus far Celsus But now Pliny in his Book 26. Chap. 1. in which he treateth of Diseases that were new and unknown in all former ages thus writeth It is recorded in the Annals that the Carbuncle the peculiar Malady of the Province of Narbone came first into Italy L. Paulus and Q. Marcius being Censors of which the same yeer two that had been Consuls Julius Rufus and Q. Lâ—canius Bassus died the former of them through the unskilfulnes of the Physitians being cut the latter he himself having put a Needle into the Thumb of his left Hand which being drawn forth the Wound was so smal that it was scarcely to be discerned It is bred in the most occult and hidden parts of the Body and for the most part under the Tongue it hath a reddish hardness like unto the Varix or crooked Vein but black in the head of it elsewhere blewish or Lead-coloured distending the Body yet not swelling up without pain without itching without any other sign or token whereby it may be known then an extraordinary propension to sleep and those that have been surprized herewith it hath taken them away in three daies time and sometimes bringing along with it a certain horror it hath round about it smal Pustules but very seldom is there any Feaver attending it and when it invadeth the Stomack and the Jaws it soon killeth Thus Pliny Now whosoever shall well weigh what he hath written shall easily perceive that he here describeth some other Disease or at the least a Disease that hath in it some thing peculiar and differing from the ordinary Carbuncle and ending in a Gangrene and Sphacelus Pliny Expresly referreth it unto Diseases new and never known before and writeth likewise that they arise in the most hidden parts of the Body and for the most part under the Tongue that it is without pain without itching without any other symptoms then sleep with which such as are surprized are deprived of life in three daies time no swelling at all appearing But now Celsus writes that it somtimes ariseth also without a Feaver and that it befalleth those parts that are about the Stomack and the Jaws whereas the ordinary and common Carbuncles arise in the outward parts of the Body and have a grievous pain joyned therewithall they likewise invade the Party with a Feaver and the place affected hath likewise accompanying it a manifest Swelling VVhat a Carbuncle is But that we may again return unto the Carbuncle that is commonly known among Tumors or Swellings it is a Swelling that hath its original from a most fervent and adust blood that corrupteth the part The Causes The Conteining Cause of a Carbuncle according to the assection even of Galen himself in his Book of Tumors Chap. 6. and in his second to Glauco Chap. 1. and his 14. of the Method of Physick Chap. 10 is a blood fervently hot and thick which in his Book of black Choler Chap. 4 and 5. he affirmeth to be black Choler To wit as we may gather out of his second Book of the Differences of Feavers Chap. 19. a Carbuncle ariseth from a fervent thick Blood putrifying and degenerating into the Nature of black Choler or having black Choler mingled with it and for the most part a certain malignity conjoyned therewithal This Swelling although it may be generated in the Body by little and little and by degrees assume this ill and depraved Nature yet notwithstanding when it hath gotten any degree of the said pravity and malignity it is then by Nature instantly and suddenly driven forth from the interior unto the exterior parts that is to say from the more noble members unto those
that are less noble and worthy Which likewise happeneth when the Blood is infected and corrupted by reason of some external Corruption from whence it is that a Carbuncle is never excited by the Congestion or heaping up of blood but is evermore generated by a defluxion that is al at once made and thereupon it is deservedly accounted among Inflammations and is said to be very neer neighboring unto a Phlegmone or Inflammation Neither is it only generated of black Choler like as a Cancer but it is bred by adust and burnt blood degenerating into black Choler or else having black Choler mingled therwith Now the aforesaid adust blood is generated from an ill and unwholsom course of Diet and from meats of a depraved and viâ—ious quality affording and supplying the whol matter of all the blood And this is likewise much more promoted and furthered by the external Constitution of the Air overheating burning and corrupting the humors and especially its occult and malignant Constitution depraving the humors and indeed there is hardly any Carbuncle to be found that is altogether void of and free from malignity The Differences Yet notwithstanding in regard that this Malignity is somtimes greater and somtimes less and that some Carbuncles invade very many in a Pestilent constiâ—ution of the Air and others again here and there seiz upon the sick without any such pestilent constiâ—ution of the Air Carbuncles therefore are to be distinguished into Pestilent and noâ— Pestilent Moreover some of them arise with a Pustule or with such Pushes as are caused and raised by the fire which if they be broken there lieth underneath within a Crusty Ulcer and this happeneth if not alwaies yet for the most part and such as these are in special by Avicen called Pruna or Ignis Perficus Others of them arise and appear without Pustules Signs Diagnostick The Carbuncle beginneth as hath been said for the most part from a smal Pustule but somtimes there is not only one of the greater Pustules breaking forâ—h but likewise many smal one like Millet seeds rising and appearing very thick in the particle which when they are broken the Ulcer becometh crusty such as is excited by a red-hot Iron But before these Pustules break forth there is a certain itching felt in the part and therby there is one or more Pustules arising and appearing yet notwithstanding the Carbuncle somtimes beginneth without any manner of Pustule and a crusty Ulcer is excited the crustiness being one while somwhat blackish another while having in it the resemblance of the color of Ashes and then again in a very short space after it groweth forth and becometh like unto Bubo's after a round acute figure with an extraordinary great heat burning and pain al which are especially exasperated about the Evening and then they so vex the sick party that he can hardly withhold his hands but that he must be rubbing of the part from which rubbing there afterward arise very many of the aforesaid Pustules The flesh that lieth round about them waxeth hot and hath in it at the heighth an extream great and burning heat it likewise obtaineth a color somwhat blacker than is that in an Erysipelas and a Phlegmone like as if there were somthing of black choler mingled together with the red There happen moreover other Symptoms besides the former to wit a Feaver which as Galen also testifieth in his fourteenth Book of the Method of Physick Chap. 10 infesteth those that are surprized with a Carbuncle more than those that are affected with a Phlegmone or Erysipelas a nauseousness likewise a vomiting a dejection of the Appetite a trembling with a panting and beating of the heart frequent faintings and swoundings dotage all which said symptoms do so much the more afflict and grieve the party by how much the matter is the more malignant For there is a certain difference even of those Carbuncles themselves not only in regard that with the aforesaid adust blood which is the conjunct cause of the Carbuncle there is somtimes this another while that humor mingled but more especially in that one Carbuncle is Pestilent and another not Pestilent For albeit every Carbuncle be malignant by reason of the hot Matter being adust and putrefying which hath in it a power and quality to corrupt the flesh and cannot wel return into any more benign or better nature neither may it wel be suppurated yet notwithstanding every of them is not Pestilent neither hath every of them any adventitious Malignity but sometimes only besides the Native malignity of the Carbuncle there chanceth likewise another kind of malignity from the common state or the contagion of the Air. But now a Pestilent Carbuncle is discerned from that that is not Pestilent first of al by the present Pestilent constitution of the Air. For it is hardly possible that a Carbuncle should arise at such time as the said Pestilent Constitution is predominant which in it self should not be Pestilent Moreover al the symptoms and signs that appear in the Carbuncle are both more frequent and more grievous in a Pestilent Carbuncle than in a Carbuncle that is not pestilent For even the Feaver also which is adjoyned unto the Carbuncle resembleth and carrieth along with it a Pestilent nature and although it seem outwardly to be more moderate and gentle than that which appeareth in the Carbuncle that is not Pestilent yea somtimes so that it can hardly be perceived yet notwithstanding at that very time it the more burneth the inward parts and is by far the more dangerous the fresh color of the face is changed the tongue becometh black and is dry the excrements of the Belly are liquid and cholerick the appetite is dejected there is likewise present a nauseousness and a vomiting of the most offensive and the worst humors a difficulty of breathing a stinking breath and there is also much sweat and this is either somwhat hot or else as we term it a cold sweat The sleep is somtimes very sound and somtimes watchings infest the sick party dotings also accompany the same as likewise faintings and swooning fits And hereupon it is that there is more danger threatned by one Carbuncle than there is by another For although every Carbuncle be not pernicious yet notwithstanding as Galen testifieth in the 3. of his Epidem Comment 3. tit 2. the most pernicious of al is the Pestilent or that which besides its own proper and particular malignity hath also adjoyned with it that which the constitution of the Air bringeth along with it and which is attended with all those pernicious symptoms which if they remit very much of their former intensness and vigor there is then left remaining some hope of safety and recovery but if from day to day they are heightened and become more vehement there is then no safety or hopes of escape to be expected The Prognosticks 1. By how much the blacker the Carbuncle is by so much the worse is
cleansing it is to be filled up joyned together and at length with a Cicatrice to be shut up But touching the cure of a Carbuncle see more in the fourth Book of Feavers and the fourth Chapter Chap. 14. Of the Tumor Paronychia UNto Inflammations there also belongeth that Tumor that the Greeks call Paronychia because that it is generated in the Confines or sides of the Fingers the Latines term it Panaritium the Germans Der Wurm Oder Das Vngenandte For the Vulgar are of Opinion that in this Tumor there lieth hid a Worm that by gnawing exciteth and causeth those so great pains and that when it is mentioned and spoken of it is thereby exasperated and that therefore it ought not to be so much at named but these things are meerly fabulous What a Paronychia is Now a Paronychia is a hot Tumor or Swelling arising from blood adust and atrabiliary in the extream part of the Fingers at the sides of the Nails and by reason of the neighborhood of the Nerves exciting most grievous and intollerable pains The Causes For this Tumor hath its original from adust and for the most part likewise malignant blood which Nature thrusteth forth unto the Fingers ends and there it causeth an Inflammation The Signs Diagnostick It is known by the Swelling Redness and pain appearing in the Fingers ends about the Nails together with a most extream and intense pain by reason that the neeâ— adjoyning Nervous parts are affected which wil not permit the sick Person to sleep or take any rest neither night nor day and this pain in regard of the Nerves consent is oftentimes extended throughout the whol Arm and it hath to accompany it a continuall Feaver and somtimes by reason of the over-great pain a Lipothymy which we term fainting or swounding Prognosticks 1. According to the benignity and inoffensiveness of the humor the malady is somtimes more mild and tollerable and somtimes again more grievous and intollerable For if the matter be benign or moderate and favorable the symptoms are then the less vehement 2. On the contrary if the Matter be Malignant the Malady is dangerous for it oftentimes so corrupteth the Ligaments and the neighboring Nerves that the utmost Joynt together with the Bone Impostumateth and somtimes the whole Finger is corrupted The Cure The Vulgar as they have superstitious Opinions touching the Cause so they have likewise concerning the Cure of this Tumor For they think that if any one thus affected shall in the Spring time wash and besmear his hands with the Eggs otherwise called the seed or Sperm of Frogs shal then suffer them to dry leisurely of their own accord and shal afterward hold in this Hand that Finger that is grieved with this Inflammation he shal by this means asswage and qualifie the said Inflammation And some there be also that every yeer hold in their hand a live Mole and then having conceived and mumbled over a certain form of words with squeezing hard they kill the Mole they have in their hand and then they brag and boast that for the yeer following they are able to kil and destroy all those Worms But to omit these sopperies the right and due way of Cuâ—ing this Evil is then taken when after the general evacuation of the humors by Blood-letting and Purgation hath been premised in the first place we impose upon the part affected those things that moderate the pain and mitigate the servent heat of the humors and such Medicaments likewise as help forward and further suppuration But Repelling and Astringent Remedies are by no means to be imposed upon the grieved part lest that by this means the humor should be the more impacted into the part the pain augmented and the Nerves and Bone corrupted If yet notwithstanding the Asslux be over great then let Repellers be laid on very nigh unto the part next above it And therefore in the very beginning the following Cataplasm is to be imposed Take Barley meal and Bean meal of each one ounce Camphire one scruple the Mucilage of the seed of Fleabane as much as will suffice Mingle all these with Vinegar over the sire and so make a Cataplams Oâ— Take the juyce of Nightshade of Plantane of Navelwort of each half an ounce the Mucilage of Fleabane seed extracted with the Water of Nightshade three drams Bole armenick half a dram Camphire five grains Oyl of Roses and Myrtle of each half an ounce Mingle them c. Or Take the Mucilage of Fleabane seed extracted with the juyce or water of Plantane two ounces Bole armenick one dram Vinegar half an ounce Mingle them c. Or else let the white of an Egg mingled with the Oyl of Violets be imposed There are likewise commended those little Worms that are found in the middle of the utmost â—ind of the Teazel or Fullers Thistle if while they are alive they be bound about the Nails affected Where the matter tendeth to Suppuration Take the Meal of Fenugreek seed and Linseed of each half an ounce the Yelk of one Egg fresh Butter one ounce the fat of a Hen three drams Mingle them without sire and make an Vnguent Or Take the Mucilage of the juyce of Fleabane one ounce the meal of Linseed and Fenugreek of each three drams the Yelk of an Egg Saffron one scruple the fat of a Hen and Butter unsalted of each one ounce Mingle them and make a Cataplasm When the Pus is bred the Impostume is forthwith to be opened and the Pus or Snot-like filth being seldom good but rotten and corrupt is to be drawn forth The Pus being thus evacuated such a like Abstersive and Incarnative is then to be made use of Take Aloes Hepatick three drams Myrrh Frankincense Sarcocol of each one dram pure and cleer Turpentine half an ounce Honey of Roses two drams Mingle them c. Gulielmus Fabricius in the first Century of his Chirurgical Observations Observ 97. doth not stay to wait for the Inflammation or for any notable swelling up and suppuration but in a Woman that was afflicted with a most grievous pain in the end of her finger together with a Feaver a fainting and swounding a nauseousness and vomiting and other symptoms he thus ordaineth his Cure He first of al a little fomenteth the finger with Cows Milk in which Camomil flowers Melilot flowers the seeds of Fenugreek and Quinces were first boyled And then by little and little he dissected the superficies of the Skin The Skin being shaven away there appeared smal red spots which being cut with the edg of a knife he findeth under the Skin a drop or two of red Water That being evacuated he applied a Linen Cloth dipt and moistened in Aqua vitae in which there was dissolved a little Treacle By thus doing he soon qualified and quite took away the pain and by this one only Remedy the very next day the finder was healed And likewise in another Matron that for three
moist and clammy Medicaments administred for by reason of such humid things applied the blood fallen forth out of the Veins is easily putrefied whereupon divers il and dangerous Symptoms are afterward wont to arise But in very truth when from a fal from some high place beating and bruising and the like Causes the blood is not only gotten together under the Skin and the external parts but oftentimes also is poured forth into the more inward parts after the same manner as it is in the Circumference of the Body when the Vessels are opened or broken which said blood is there clotted and corrupted and is wont to cause Inflammations and the worst sort of Feavers dangerous Symptoms and very frequently death it self we must therefore use the best of our endeavor that the clotting and growing together of the aforesaid blood may be hindered that it may be dissolved and that it may be evacuated by stool urine or sweats and that with al due and possible speed For when once the blood hath gotten a putridness the Malady is not so easily cured nor indeed at al without the most exquisite and singular extraordinary Remedies Wherefore so soon as there is any the least suspition that the blood is fallen forth without the Veins into the more inward parts and that it cannot be dissipated by external Remedies we must then use these things following to wit Rheubarb Rhapontick Terra sigillat Sperma Ceti in the Shops termed Patmasitty the Eyes of Crabs Mummy red Corals Harts-born Madder such as the Dyers use in coloring with the Waters of Cherefoyl Carduus Marjoram St. Johns wort Fumitory Alkekengy Card. benedict Scabious the Syrup of Sorrel Syrup de Acetositat Citri Vinegar and the like which what they are will appear further from the following Receipts and Prescripts Take Rheubarb Terra sigilat Bole armenick Mummy of each one dram make of these a Pouder of which give one dram at once with the Water of Cherefoyl or Shepherds-Pouch Or Take Terra sigillat Crabs Eyes of each one scruple Sperma Ceti Goats blood prepared Angelica and Gentian Roots choyce Rheubarb of each half a scruple seeds of Carduus Bened. seven grains Cloves three grains Make of these a Ponder for two Doles to be taken at twice and drunk with the following Waters Take the Water of the Infusion of Lavender one ounce the Waters of Cherefoyl St. Johns wort Strawberries of each one ounce and half Wine Vinegar half an ounce for twice Or Take Terra sigillat Madder Mummy great Comfrey Rheubarb of each a scruple mingle them and make a Pouder Or Take Rheubarb the Root of Madder Mummy Crabs Eyes the seed of Carduus Mariae or Mary Thistle the Root of round Aristolochia or Birthwort of each one dram mingle and make a Pouder give hereof a dram at once with the Syrup of Sorrel Some there be likewise that commend the Water of Nuts They commonly administer one dram of Sperma Ceti dissolved in Vinegar or some fit and convenient Water There are likewise some that make use of Unguents and that with good success also which are likewise taken into the Body and are therefore stiled Potable as for instance the Potable red Unguent of the Ausburg Practitioners Or Take Green Sanicle four ounces the Leaves of Betony Fennel seed Juniper Berries unripe of each three ounces the Root of Elecampane of the greater Comsrey Rue Ground Ivy Rosemary Rhapontick root of each two ounces all these being shred very smal let them be stirred about and incorporated with three pound of fresh Butter Set them then in the Sun for eight daies afterward put thereinto one Cyath or little Cup ful about two ounces of Sanide Water then boyl it til the water and juyces be quite consumed and then let the Butter thus incorporated and moistened with the Juyces be pressed forth and kept for use The Dose is half an ounce twice a day to be taken with warm Beer the place affected may likewise be outwardly anointed with the same yet not at the first beginning and appearance of the distemper but some while after Or Take these Herbs Wormwood Southernwood of each two handfuls the Herb Ladies Mantle Motherwort or Mugwort the lesser Comfrey the lesser Sage Germander the lesser Centaury Crosswort Fennel Strawberries Fenugreek Ground Ivy or Aleboof Hyssop Lavender Milfoyl Marjoram Balm Bugle Penyroyal Pyrole or Winter green Pimpernel Rosemary Sage Sanicle Savory Spicknard Betony Vervain of each one handful the roots of Marsh-mallows Clove-gilliflowers the greater Consound Angelica Pimpernel and Tormentil of each of these one ounce These Herbs and Roots gathered green in the month of May or June boyl in six pound of May Butter adding thereto as much Wine as you judg sufficient let them boyl together until they be boyled enough stil taking heed that they burn not to and in the end adding of the Oyl of Bayes fresh and new four ounces Sperma Ceti half a pound Make herewith an Unguent of a green color the Dose is one ounce in Vinegar or Beer and this may likewise be outwardly applied unto Wounds Or Take the Roots of Tormentil Dittany Sanicle the greater Consound Consound Sarracen of each two ounces Castoreum one ounce that sort of it that is offensive by reason of its unpleasing tast may be omitted Madder three ounces May Butter three pound red Wine as much as will suffice mingle and boyl them till the Wine be consumed herewith make an Vnguent adding thereto of Sperma Ceti one ounce As for the Topicks at the first beginning some Astringents are to be mingled with the discussive Medicaments For when the Tunicles of the Veins out of which the blood is poured forth are somwhat bruised they ought then to be a little strained together bound fast and condensed lest that the new matter drawn thither by pain be poured forth since that if in the beginning only Digestives be administred they wil not only discuss the blood poured forth of the Veins but attract and draw unto the part that blood that is in the bruised smal Veins Afterward that the little contused or bruised Veins may return unto their Natural state Digestives alone are to be made use of For this end and purpose some there be now this indeed is the best kind of Remedy especially for those that are beaten that wrap about the sick person the Skin of a Ram new flaid off and whilst it is yet hot besprinkled with Salt Myrtle Berries and the Pouder of Water-Cresses or if such a skin may not conveniently be gotten they anoint the Patient with the Oyl of Roses of Myrtles and of Earthworms with which they mingle the Pouder of red Roses or Myrtle Berries and the day following such a like Liniment may be administred Take Vnguent Dialthaea three ounces Oyl of Earthworms Camomil and Dill of each one ounce Turpentine two ounces the meal of Fenugreek the pouder of red Roses and Myrtles of each half an ounce Saffron one scruple make
in the first place Scarification is to be administred or likewise if need so require Cupping-glasses are to be applied that so the corrupt blood may be evacuated After this the part is to be fomented with warm Vinegar or the Decoction made of the Reddish Root of Serpentaria or Vipers Grass Cuckowpint Solomons Seal and Wine as much as wil suffice For such like Remedies dissolve the clotted blood and draw it forth from the very bottom unto the outmost part of the Skin And after let there be applied the Diachylon-Flower-de-luce Emplaster Or Take Southernwood Cumin Seed Camomilo Flowers of each one dram the Juyce of Wake-robbin or Cuckowpint as much as will suffice make hereof a Cataplasm Or Take Oylan ounce and half Wax an ounce the Juyce of Marjoram an ounce and half let them dissolve together at the Fire and then add of the Spirit of Wine one ounce And to conclude that which Paraeus adviseth is to be taken notice of to wit that in the contusion of the Muscles and especially those about the Ribs the Flesh a little swelleth up and becometh as it were snotty and purulent insomuch that if it be pressed down and squeezed together is sendeth forth a flatulent Air with a certain kind of low noyse and gentle hissing and withall the print and impression of the Fingers remaineth and is to be seen for some while after And therupon in that void space that the Flesh separating it self from the Bones hath lest there is a purulent and rotten filth gathered together by which there is caused a syderation and putrefaction If therfore this shal happen the Malady is speedily to be taken in hand the best means used and the part most strictly and closely to be drawn together and furthermore Oxycroceum or Ireat Diachylon or the like Digestives are to be administred And thus much shall suffice to have been spoken touching Tumors arising from the Blood there now follow those Tumors that arise and proceed from Choler Chap. 17. Of the Tumor Herpes HAving hitherto treated of and explained the Tumors arising from the blood it now remaineth in the next place that we likewise explain and declare those Tumors that proceed from Choler Among the which the Erysipelas is commonly wont to be first propounded and reckoned up But since that as we conceive the Erysipelas as it is now adaies with us or as it hath been by the Ancients vulgarly termed Rosa may more fitly be recounted among the Tumors arising from the blood we have therefore treated thereof above among the Tumors proceeding from blood in the seventh Chapter wher we handle the Erysipelas But now Herpes is truly and properly a Tumor proceeding and taking its original from Choler And it is termed Herpes from its creeping to wit because it seemeth to creep like unto a Snake and for this reason because that no sooner doth one part seem to be healed and wel but the Disease instantly creepeth unto the next adjoyning parts And although to speak truly there are very many Maladies that Creep along yet in special that Tumor is by Physitians termed Herpes that is excited in the superficies of any part from yellow choler sincere or simple that is severed from all other humors and from thence creepeth along unto the parts next adjoyning For as the Erysipelas ariseth from blood very than and choletick so the Herpes proceedeth from excrementitious Choler Celsus seemeth to propound and mention Herpes under the name and notion of Ignis Sacer or the Sacred Fire whereas other Latine Physitians understand an Erysipelas under this appellation of Ignis Sacer. The Causes The conteining Cause of Herpes being sincere pure and sharp Choler severed and separated from the rest of the humors which by its implanted thinness penetrateth and pierceth even unto the outward or Scarf-skin and is by and through it diffused it hence appeareth and by consequence followeth that the Tumor or swelling in it is yet less than in an Erysipelas For as in an Erysipelas the Swelling is less than in a Phlegmone by reason of the smal store and thinness of the matter that is found in the one more in the other less so again in the Herpes the swelling is less than in the Erysipelas for the very same cause But as for the Antecedent and Procatartick Causes they are almost the very same as in an Erysipelas yet notwithstanding somwhat more disposed to the generating of an excrementitious yellow choler then to the breeding of a cholerick Blood The Differences The Differences of Herpes are taken from the diversity of the conteining Cause and the humor For although every Herpes hath its original from Choler and a thin humor yet notwithstanding since there are certain degrees of its tenuity thinness and purity if that humor or choler be simple and of a thin substance then the Affect that reteineth the general name is termed a simple or single Herpes But then if there be any portion of Flegm mingled therewith there is produced an Herpes that causeth and raiseth little Bladders in the Skin like unto the Millet whereupon it is called Herpes Miliaris And lastly if the Choler be more sharp and biting so that it eat through the skin unto which it adhereth it is then termed Herpes Esthiomenos that is the eating Herpes and this same by Galen in his 14. Book of the Method of Physick Chap. 17. is called absolutely and only Herpes and is almost of the same nature with an exulcerated Erysipelas from which notwithstanding it differeth in the thinness of the humor For so saith Galen in the place before alleadged It is saith he an exceeding thin humor that exciteth the Herpes even so thin that it doth not only pass through all the interior parts which likewise are of a fleshy substance but also the very Skin it self even unto the utmost part of the Scarf-skin the which alone in regard that it is kept in and reteined by it it both gnaweth and likewise eateth through whenas if it could also in like manner pass through it by sweating it would not then excite and produce any Vlcer But now the exulcerated Erysipelas and the Herpes Esthiomenos differ likewise in this regard that the exulcerated Erysipelas doth not only seiz upon the Skin but also upon some part of the Flesh that is underneath it but the Herpes exulcerateth only the Skin Signs Diagnostick In regard that the Herpes is apparent and manifest unto the Senses it is therefore easily known For it is a broad Tumor that hath little or no heighth in it so that the part is scarcely lifted up at al but may seem rather to be exasperated then to swel up unto any heighth There is moreover present to accompany it a certain kind of hardness and a pain and as it were a certain sense and feeling of an heat and burning But the Herpes Miliaris hath divers smal Pustules like unto Millet in the very top and outside of the Skin of the
Barley Lentiles Beans of each one handful Arnogloss or Lambs Tongue two handsuls Pomegranate flowers Roses the grains of Myrtle Sumach of each half an ounce Let all except the Barley be grossly poudered and then boyl them in Wine until the Barley be soft and make hereof a Cataplasm Or Take the Rinds of the Pine tree burnt and washed a dram and half Ceruss three drams Frankincense one dram Goats fat six drams Oyl of Myrtle two ounces Wax at much as wil suffice make herewith an Vnguent But if we have a mind to dry more than ordinarily we may ad the prepared file-dust of Iron the flower of Brass and Lime washed This is likewise commended Take the spume or froth of Silver half an ounce the juyce of Leeks and Beets of each sive ounces Mingle them c. Hieronymus Fabricius writeth that with very good success he made use of this following Remedy Take the juyce of Tobacco three ounces green or Citron-coloured Wax two ounces Rosin of the Pine tree an ounce and half Turpentine one ounce Oyl of Myrtles as much as wil suffice for the making and forming of a soft Seoer-cloth But if the Ulcer be already putresied we must then betake our selves to the Remedies that are stronger and more forcible such as are the little sweet Bals of Andro Musa and Polyidas a for example Take Litharge and Ceruss of each two ounces the Rinds of Pomegranates half an ounce Myrrh one dram Frankincense a dram and half the flower of Brass and Allum of each a dram and with the Oyl of Myrtle and Waie a sufficient quantity of each make an Vnguent But if these wil not serve the turn and that the Ulcer and putrefaction creep further and become broader we must then have recourse unto the stronger sort of Remedies They refer likewise unto choletick Tumors those that we cal Phlyctaenae Impetigines Lichenes Sudamina and Epinyctides But because that these little risings or swellings proceed not from pure Choler but from Choler mingled with serous and salt Humors we wil therefore treat of them below with the rest of the Tumors of this kind Chap. 18. Of the Tumor Oedema LIke as those Tumors that we have already hitherto handled have their original from hot Humours so there are likewise some certain peculiar Tumors that arise from cold Humors and in the first place Oedema that hath its original from Flegm For although Hippocrates and other ancient Physitians under the name of Oedema understand al other Tumors whatsoever in general yet notwithstanding those of latter times by Oedema do understand some one certain kind of Tumor only and this they specially term Oedema being a Tumor that is lax or loose soft without pain yielding unto the touch and compression of the singers having its original from thin flegm or else from the more cold and moist part of the Mass of blood The Causes The containing Cause of this Tumor is that flegm that is contained in the blood to wit if it be so increased that it irritate and stir up the Expulsive Faculty For then Nature being stirred up and provoked thrusteth forth the matter out of the greater Vessels unto the less and expelleth it from the more noble parts unto the weaker until at length it be received and retained by the most weak and infirm part The cold and heavy Humor it self likewise very often by its own weight tendeth downwards and also unto the extream parts And thereupon it it that although the Oedema may be excited in al parts whatsoever of the body yet notwithstanding it chiefly and more especially ariseth in the Hands and the feet as it evidently appeareth in Persons that are Hydropical Cachectical and Phthisical in regard that those parts are more remote from the fountain of heat But now this Oedema is not suddenly generated but by degrees and by little and little For why the Humor is thick and therefore altogether unfit for any speedy and sudden motion Galen in his second Book to Glauco and third Chapter determineth that the Oedema is caused by a Pituitous or flegmy substance or else by the Spirits when they are ful of vapors and such a like Tumor or swelling happeneth in dead Carkasses From which place as likewise from the 14. of his Method of Physick Chap. 4 Johannes Philippus Ingrassias in his Book of Tumors the first Tome page 113. endeavoreth to prove a twofold kind of Oedema the one from thin flegm the other from a vaporous spirit and that to wit the former he asserteth to be a Disease and the latter a Symptom only that followeth upon Phthisis and the water betwixt the Skin one species of the Dropsie and the Cachexy But yet although it be not to be denied that Carkasses in the very first beginning of there putrefying and as it were a certain kind of fermentation swel up in some sort yet that in the Cachexy or Phthisis the Oedematose swellings of the Feet should in this same manner be caused I cannot easily beleeve in regard that such a like putridness doth not then happen but it is far more credible that such like Tumors are caused from a serous wheyish Humor abounding in the body and descending unto the Feet and there abiding and sticking fast as in a part more cold than the other parts of the Body And be it indeed granted and admitted that in the similar parts there may be some kind of slatulent Spirit collected and that it may lift up the part into a Tumor yet notwithstanding this Tumor is not properly Oedema but is rather to be termed Empneumatosis or Emphysema And albeit such a like Tumor is by Galen in his 14. Book of the Method of Physick Chap. 4. called a Symptom yet we say that Galen then useth the name of a Symptom in the general for every Affect preternatural that followeth another But if we wel weigh and consider what this Tumor properly is we affirm that it is altogether and in al respects a Disease in regard that it is magnitude augmented and for the most part an impediment and hindrance unto men in their walking And although such an Oedema doth not indeed requite a peculiar Cure yet notwithstanding it is not for al that to be razed out of the number of Diseases and placed among the Symptoms For those Diseases that simply depend upon other Diseases require not any proper and peculiar kind of Cure but those being removed these likewise are taken away But now that very Humor that is the cause of Oedema is generated by an error and default in the sangnification touching which we have spoken in the third Book of our Practice third Part second Section and first Chapter The Signs Diagnostick Oedema is known in this manner The Tumor is soft and loose and if it be pressed down with the singer it easily yieldeth and giveth way by sinking and so there is a little pit and print of the singer left behind For the moist
the moisture be consumed and then with a sufficient quantity of Wax and adding thereunto Ammoniacum and Galbanum dissolved in Vinegar of each three drams and Flowerdeluce Root wel bruised two drams make an Emplaster Or Take Ammoniacum Bdellium Galbanum Opopanax Styrax liquid dissolved in Vinegar of each one ounce Litharge of Gold ten drams let them boyl in Vinegar afterwards add Pellitory live Sulphur of each half an ounce Oyl of white Lillies and Wax of each a sufficient quantity Make an Emplaster But now in the administring of these Medicaments we ought alwaies seriously to observe whether the Scirrhus arise from flegm or else in truth from a Melancholick humor For if it hath its original from this last it is then more warily and cautelously to be handled than if it proceeded from flegm lest that it turn into a Cancer and especially if it incline toward a suppuration we must have a care that it be not too much irritated by hot Medicaments Chap 20. Of a Cancer THe Cancer by the Greeks called Carcinos and Carcinoma so termed because it resembleth the Water-Crab or Crevish is generated from an adust Humor or black Choler And yet notwithstanding Celsus seemeth to put a difference between Carcinoma and Cancer For in his fift Book and 28. Chapter he calleth the disease that we treat of in this Chapter only Carcinoma But in the same Book and 16. Chapt. he giveth the name and appellation of a Cancer in general unto certain creeping Ulcers under which he likewise comprehended the Erysipelas that is exulcerated the Gangrene also and the Sphacelus But yet notwithstanding al other Physitian whatsoever use the words Carcinoma's and Cancers as Synonyma's that is as words signifying one and the same Disease For a Cancer is a Preternatural Tumor arising from black Choler round of a wan color or somwhat blackish painful and which when the Veins every where round about are filled and strut out resembleth the feet of the Crab Crevish or Crawfish The Causes The Cause of a Cancer is black Choler in which either yellow Choler or the Melancholy Humor hath degenerated by reason of its being burnt For the Melancholy Humor while it yet continueth to be Natural and is not yet burnt doth never cause or produce a Cancer but another Species or kind of Scirrhus But from the black Choler alone if it be burnt which sticketh fast in the Veins neither can it by reason of its thickness penetrate into those streight and narrow passages as the Melancholy humor doth that causeth the Scirrhus the Cancer is excited and generated But now of this black Choler there is a certain difference for some of it is more mild and moderate or less hot and sharp but then another sort of it is very sharp and hot That which is more mild causeth a secret hidden Cancer that is not exulcerated but that that is more hot and sharp exciteth an exulcerated Cancer Now the said black Choler is more or less sharp according as it is more or less burnt or arise from a humor that is more or less sharp Whereupon it is That that which proceedeth from yellow Choler adult and burnt is worse than that which hath its original from a Melancholy humor And leek by how much the longer it abideth in the place affected and by how much the more it is putrefied and burnt by so much the more it is rendered the worse And hence it is that the Natural Melancholy humor also which first exciteth a Scirrhus if it stick and abide long in the part and especially then when it is not handled with al care and caution in the applying of heating and moistening Medicaments it afterward exciteth and causeth a Cancer But whether the Cancer be without any Ulcer or no and whether the black Choler be mild and moderate or else exulcerated and the cause more sharp yet however notwithstanding in and of it self it is alwaies without a Feaver although accidentally a Feaver may happen thereupon In the mean time we say the Cancer it self is a hot Tumor For although some there be that doubt whether a Cancer be to be ranked and reckoned up among the hot or the cold Tumors as there be likewise that question whether black Choler be a hot or a cold humor and although by the Arabian Physitians a Cancer is accounted and reckoned up among the cold Tumors and Galen seem to incline thereunto in his Book of black Choler Chap. 4. and in his 2. to Glauco Chap. 10. yet notwithstanding it is by the same Galen in his Book of Tumors Chap. 8 10 11. most rightly and truly reckoned up among the hot Tumors since that it hath its original not from the Melancholy humor cold and dry but from black Choler hot and dry For albeit the Melancholy Humor may possibly give the first occasion of this Tumor yet however notwithstanding the Cancer is not generated from it unless the said Melancholy Humor degenerate and turn into black Choler whether this happen in the Vessels or in the part affected like as somtimes a Scirrhus as ere while we told you that is produced from a Melancholy Humor may pass and turn into a Cancer And this is the conjunct cause of a Cancer to wit black Choler a humor hot and dry sharp Salt corroding and corrupting al things generated and bred from the heat of other humors the heat now ceasing or at least being not so vigorous that it may excite and cause a Feaver as it is wont to be in a Phlegmone and Erysipelas It is likewise generated from other Causes For now and then a hot distemper burneth up and inflameth the Humor and so generateth black choler and somtimes the Food Meat and Drink being such as hath in it a disposition and tendency unto the generating of such a like humor by the frequent use thereof and in process of time becometh the Cause of black Choler and somtimes the very Spleen it self being grown weak and not able to attract and draw unto it self that that is generated of the Melancholly humor doth thereupon leave this humor in the Body which after it hath been for a while deteined in the Body is inflamed and burnt up The very same likewise happeneth if either the monthly Courses in Women be suppressed or the Hemorrhoids obstructed And in truth the Cancer is generated and bred in all the parts both external and internal and yet notwithstanding it especially appeareth as Celsus tels us in his fifth Book Chap. 28. in the superior parts about the Face Nosethrils and Ears Lips the Paps or Breasts of Women which chiefly by reason of their laxity and loosness do very easily receive that humor and then again in regard of the consent and agreement it hath with the Womb they readily admit of those vitious and naughty humors that ought to have been purged forth through the Womb. The Signs Diagnostick At the first beginning the Cancer is not so easily
known because that at first it is scarcely so big as a Vetch or a Bean but then afterwards when it is grown and hath gotten so much augmentation and enlargement that it is now lift up into a greater bulk it hath with it then signs and symptoms so evident and so grievous that it by any one may be most easily known For this Tumor is hard it hath a leaden or wan or blackish color and yet notwithstanding this is more or less such according to the diversity of the matter There is present likewise a pain to attend it the which although it may indeed be sometimes greater and somtimes less yet notwithstanding the Cancer is never wholly without it There is likewise present an heat pulsation or beating and round about as it were in a Circle it hath Veins distended and strutting out with black Blood Now although the Scirrhus arising from a melancholly humor hath some kind of likeness and affinity with a Cancer yet notwithstanding by the aforesaid and other signs it may easily be discerned from it For a Cancer hath evermore a pain and pulsation conjoyned therewith together with an heat more than ordinary and most commonly it beginneth of it self and suddenly getteth encrease so that from a very smal and inconsiderable bigness it becometh exceeding great and bulky and there is for the most part a humor residing in the Veins which said Veins being therewith filled very full resemble the Feet and Claws of Crevish or Craw-fish But now in the Scirrhus there is no pain appearing and for the most part it hath its original from the Change and alteration of other Tumors and the humor that produceth the Scirrhus doth not chiefly and principally reside in the Veins but in the spaces and Pores of the Parts from whence also it is that the Veins are not ample wide and large neither turgid and strutting out and the increasing and growth thereof is much more slow than that of a Cancer But now if the Cancer be already Ulcerated then the Ulcer is nasty and stinking the lips are swoln thick and pale or wan The Prognosticks 1. In the general every Cancer is a most grievous and a dangerous Disease and such as is seldom or never cured For the Cause thereof being over thick is obstinate and malignant and oftentimes it seizeth and surprizeth even those Veins also that lie low and deep insomuch that it cannot be removed and taken away either by the purgation of the Body or by Repellers or Discussives or cutting and lancing or lastly even by actual Cauteries and burning for as for the milder sort of Remedies it sleights and contemns them and as for the stronger sort of Medicaments it is by them exasperated 2. Where there are secret and hidden Cancers there it is best not to cure them For they that are cured die within a very short time after but those that are not cured of these aforesaid Cancers live a longer time so saith Hippocrates in the sixth of his Aphorisms Aphor. 38. For why those Cancers that before were not exulcerated when they have Medicaments applied to them may and do easily become exulcerated 3. They likewise that have Cancers in the Cavity of the Body or in the palate of the mouth or in the Buttocks or in the Womb if they be either cut or burnt the Ulcers cannot by any means be healed up and covered over with a Cicatrice But those that are thus affected while they lie under Cure are tortured and tormented even to death by the afflicting pain they undergo whereas without a Cure and if they shall not at all submit themselves unto the means tending thereunto they may live a longer time and with far less trouble and grievance as Galen hath it iâ— his Commentary upon the aforesaid Aphorism of Hippocrates 4. Those Cancers only therefore are to be attempted in the way of Cure which are and appear in the outward part of the Body and there likewise it will be more safe to attempt the Curing of them by Medicaments in the very first rise of them while they are yet but smal and inconsiderable than when they are grown and become great for then they are not to be cured without the help of the Hand which we term the Manual operation neither indeed so unless they have their residence and situation in those parts that may without danger be lanced and burnt together with the very Roots that is to say the Veins in them that are full of burnt of adust blood 5. For when the Cancer hath once gotten possession of a great part or when it sticketh fast in a more noble part or any other that may not safely and conveniently be cut or burnt it is then altogether incurable 6. Yea moreover in the general there are very many and indeed the most Physitians that are of opinion that no Cancer confirmed and exulcerated can possibly be cured And it is oftentimes observed That although Cancers be cut out and now and then cured in the external parts Yet notwithstanding that the same have returned again either in the very same part or else even in some other parts as for instance when the Cancer hath been cured in the paps or breasts another hath soon after risen and sprung up in the Womb. And therefore we ought rather so far forth and no further to cure those Cancers that are already inveterate and of the greater size that their further growth and augmentation may be impeded and hindered Whether an exulcerated Cancer be contagious Zacutus Lusitanus will have it to be contagious he proveth it 1. From Reason Cardanus in his first Book of Poysons and 12. Chapter affirmeth that the Cancer is not contagious and yet he giveth us no reason at al for this his Assertion but presupposeth and taketh it for granted as a thing apparent and manifest Neither to my best remembrance do I know any one who accounteth and esteemeth the Cancer to be in the number of contagious Diseases excepting only Zacutus Lusitanus in the first Book of his Practice and Administr of Physick and 124. Observat who doth it and endeavoreth to prove it both by Reason and Experience His Reasons are 1. Because that in an exulcerated Cancer there is present a certain putridness and noysom stench as it were of a dead Carkass that by its purulency infecteth the body that is nigh unto it His second Reason is Because the Cancer is the same Disease with an Elephantiasis and Leprosie of one only Member but now the Elephantiasis is most contagious An Answer thereto But these his Reasons do not sufficiently conclude any thing For first Al things that are putrid and ill favoured and noysom are not contagious For in a Gangrene and Sphacelus there is an extraordinary putridness and stench and yet notwithstanding the stander by is not therewith infected And moreover although a Cancer hath some kind of similitude and resemblance with an Elephantiasis they are
and Chap. 8. maketh a twofold sort of this Tumor differing according to the Nature and quality of their Causes The one he deriveth from cholerick blood the other from a salt and nitrous Flegm but this more rare Others there are that assert that this kind of Tumor doth arise from an exhalation or vapour of hot fervent Blood or else the admixture of the Cholerick and Salt humors The Causes Whosoever knoweth and understandeth the Nature of serous wheyish humors wil not deny that such like Tubercles may possibly be excited from serous or wheyish humors being such as are sharp and easily moved and likewise such as without much ado vanish and are discussed Which appeareth and may be confirmed even from hence that this Malady may be and is removed especially by Venesection or blood-letting which said Venesection doth chiefly and principally qualifie and allay that extream and fervent heat of the serous and wheyish part of the blood Yet notwithstanding the itch that is somtimes greater and somtimes less likewise teacheth us that there is not one alone difference of this wheyish humor but that somtimes this said whey is more mild and moderate and somtimes again more sharp and hot somtimes thinner and somtimes thicker as likewise thus much which I my self have very often observed that these Tubercles while the the Patients are in a hot place they then break forth and appear and that when they expose themselves unto a cold Air the Essere then vanish and as soon again on the contrary to bud forth in the cold Air and to vanish in a hot place the former whereof seemeth from hence to happen to wit because the humor is very thin and moveable and therefore is instantly driven in again by the cold ambient Air but the latter because the Humor is not altogether so movable and thin but somwhat more thick which for that very cause cannot transpire in a cold Air but in a hotter Air it wil transpire or breathe through But this wheyish and thin Humor is for the most part generated from the fault of the Liver which from some preternatural cause is disposed to generate and breed this humor Now that said Humor waxeth extreamly hot from the Causes Procatartick as they cal them that stir and move the blood And this happeneth likewise in the Winter time and in cold Regions rather than in hot Signs Diagnostick It is easily known by those notes and marks that are above mentioned to wit there somtimes goeth before an Ulcerous Lassitude and then there break forth in the whol body itchy Pustules as if the party had been pricked by Bees or stung with Nettles The Prognosticks 1. These Tubercles vanish of their own accord within a very short space although there be no course taken for the curing of them and they are not suppurated neither doth there issue forth of them any humidity at al. And if this should somtimes so happen yet this chanceth rather by reason of the scratching of them and also from the vehemency of the Itch which is extream troublesom to the sick persons than by means of the Tumor 2. Somtimes these Essere go before Cholerick Feavers and therefore such as are very frequently molested and grieved with these Tubercles ought not in any case to neglect the Cure lest that they fal into Feavers and some more grievous Disease The Cure For the most part there is no need at al to administer Topicks but if the fervent heat of the Blood and Humors be by Venesection and the administring of Medicaments that alter qualified and kept under the Tubercles wil then soon vanish and the smoothness and Natural color will forthwith return unto the Skin To wit in the first place a Vein is to be opened and so much of the blood drawn forth as the state and condition of the body requireth And afterwards if there be any need at al thereof the Cholerick and wheyish Humor is to be drawn forth by Tamarinds Myrobalans Rheubarb afterward let there be administred the Juyce and Syrup of Pomegranates Ribes Syrup de Agresta or Varjuyce Whey with the Emulsion of the four cold seeds and the like Milk tart and sowr c. It is likewise very requisite to put the sick person into a Bath of warm Water Let his Diet likewise be cooling and moistening Chap. 27. Of Scabies or Scabbiness SCabies or Scabbiness ariseth likewise from adust matter as doth also the Itch that is as it were a certain Praeludium and forerunner of Scabbiness and the like Affects Now Scabies by the Greeks and Latines is called Psora an Affect sufficiently known in the which there is not only present some kind of foulness and deformity of the body but a distemper also even of the very Skin together with a swelling and exulceration from whence it is that the actions of the Skin are likewise hurt But more especially in the Scabies or Scabbiness the top and utmost part of the Skin is affected insomuch that out of it as Galen tels us in his fourth upon the Aphorisms and the 17. Aphor. there is some such like thing cast forth that beareth a likeness and resemblance with the casting of Serpents From whence it likewise differeth from the Itch for in the Itch there is only a roughness of the Skin in which there is nothing that fals off notwithstanding the scratching whereas in the Scabies there is not only a roughness of the Skin but likewise a distemper with a swelling from which by scratching the bran-like bodies are easily and readily separated and together with them divers Ichores likewise and filthy purulent Excrements The Causes But what the Cause of the Scabies is in this Authors seem not so wel to agree Galen in his Book of Tumors Chap. 1. 3. tels us that Sabies also and Lepra are Melancholick Affects and likewise in the seventh Sect. Aphor. 40. that Cancers Elephantiases Lepra's and Psora's are al of them Melancholy Affects and the same he also tels us in other places But Avicen in the seventh Book of his fourth Tome Tract 3. Chap. 6. writeth that the matter of Scabies is the blood with the which Choler is mingled and that converted into Melancholy or salt flegm and with him the other Arabian Physitians agree But the very truth is that although in the Scabies the humor be not alwaies one and the same yet in every Scabies there is some kind of mixture of the adust and melancholy hot and dry humor And furthermore there is one sort of Scabies that is moist another that is dry The moist in the which there sloweth forth a certain matter that is moist and withal rotten filthy and purulent but the dry is that in which there is but little or none of the aforesaid matter cast forth And concerning this latter it is that Galen seems to speak as being such wherein that melancholy humor doth more superabound But Avicen and the rest of the Arabian
Physitians understand hereby al kind of Scabies whatsoever Now albeit the next cause of Scabies be a humor sharp and salt yet notwithstanding Avicen doth not altogether absurdly assert that blood is the matter of the Scabies For seeing that Scabies is an Univerversal Affect of the whol Body it cannot therefore easily proceed from any other humor unless that blood be likewise therewith mingled and yet notwithstanding the blood cannot properly be said to be simply the cause of Scabies to wit so long as it retaineth its benign and tempeperate Nature For whilest it continueth benign and good it can in no wise excite and cause the itching neither yet those Ulcerous Tumors or Swellings Wherefore before such time as the blood can possibly produce and breed the said Scabies it must of necessity be corrupted and other humors that are sharp and biting there with mingled And true it is indeed that yellow Choler is sharp and corroding but then it scarcely floweth in so great abundance or is of that thickness as to excite such like Tumors But black Choler and salt Flegm are Humors very fit and most apt to produce the said Scabies For these Humors being thick hot and dry and withal biting and corroding if they chance to be thrust forth unto the Skin there they stick fast in it and there they excite a hot and dry distemper an itching a swelling and an exulceration But now as for the primitive Causes and more especially for the generating and breeding of those salt biting and sharp humors the kind and ordinary course of Diet that is kept doth exceedingly advance and further the same Meats to wit of a bad juyce and that afford an unwholsom and corrupt aliment such as are salt sharp and that are easily corrupted And hence it is that the poorer sort of people who live upon these kind of unwholsom corrupt meats are most frequently infested with the Scabies or Scabbiness as likewise Children and yong people in general in regard that these are altogether careless and heedless in their Diet whereupon they contract great store of excrements that being retained in the outward part of the body are there corrupted and so they get an acrimonious quality But then from these bad and naughty meats those sharp and salt humors are the more easily bred if there be present a hot and dry distemper of the Liver And hitherunto likewise relateth the uncleanness and nastiness of the body to wit when there is altogether a neglect in the keeping it sweet and clean and if the foulness and impurities of the Skin be not duly washed off or the garments not shifted and changed often enough whereupon it is that filth and impurities sticking in the superficies of the body do not permit so free a passage forth unto the excrements and by this means the said excrements acquire a certain acrimony and so corrupt the other humors The Scabies ariseth likewise somtimes after a Crisis and after Diseases both acute and those also that are of a long continuance to wit when Nature expelleth forth unto the Skin those naughty and depraved humors which it is not able any other way to discuss and evacuate And lastly Congium is likewise accounted and reckoned up among the principal causes of Scabies which cause Galen also acknowledgeth in his first Book of the Differences of Feavers Chap. 2. and Book 4. of the Differences of Pulses Chap. 3. For in the Superficies of the Skin of those that are Scabby there is a certain viscous and clammy moisture gathered together which being either by the Apparel oâ— by some other means communicated to the body corrupteth the humors therein after the like manner and produceth the like Affection and that especially in these bodies that are now already disposed unto the Scabies And indeed the humid or moist Scabies is the more contagious in regard that in this there is generated more of the aforesaid viscid and clammy humidity The Differences Some there are that reckon up very many Differences of Scabies as that one is new another old and inveterate and that one seizeth upon the whol Body another upon the Hands only and the Thighs but the main and special Difference is that which is taken from the Difference of the Humors that one ariseth from a black and melancholy humor and this is called a dry Scabies in which although there be a concurrence of other humors yet notwithstanding the greatest part thereof is of this last mentioned humor from whence it is that out of the parts affected with this Scabies either there is nothing at all sent forth or if there be any thing issuing our it is thick dry and the Ulcers themselves as likewise the prints and footsteps as we may so term them of these Ulcers are wan and pale and somtimes black another is humid and moist in which there aboundeth a salt flegm out of which there plentifully floweth forth much moist filth and corruption that is thin and subtile sharp and now and then likewise it wil be thick Signs Diagnostick The Scabies or Scabbiness is an Affect very wel known and it may easily be discerned as may also its Differences and from those signs and tokens especially that we but even now mentioned And yet notwithstanding those signs do now and then vary and are somthing changed according as the aduition of the other humors is greater or less Prognosticks 1. Now although the Scabies be in this respect troublesom to wit in regard of the foulness and deformity that it causeth in the Skin rather than that it bringeth with it or threateneth any other danger nigh at hand and that in youth it oftentimes preserveth and likewise freeth from other Diseases yet notwithstanding it is not alwaies secure and safe For if it be of any long continuance it may and somtimes doth turn into the Lepra or Leprosie and in Ancient persons it is contumacious and stubborn and hard to be cured 2. And among the several species and kinds of them the dry is more difficult in curing than the moist And therefore whatever kind or sort it be of it is not at any hand to be neglected but by a due and fit Cure even for the very deformities sake if there were no other cause speedily to be taken away and removed Of the Scabies retiring inwardly That Scabies that hath its rise and original not from any contagion but from some internal default of the humors for the most part breaketh forth as it were critically and ariseth from some internal vice of some one or other of the Bowels in which so soon as any vitious humors are generated they are immediately by Nature thrust forth unto the outward part of the body the which motion if Nature be not able to perfect and accomplish it or in case she be by Medicaments administred unseasonably hindered in her operation divers Diseases are from hence excited Many Diseases proceeding
much the better and far less afflicted with the aforesaid Malady than formerly he had been For Beer is much thicker than Wine and therfore it also breedeth and supplieth a more thick and gross blood The Prognostick This Malady is very hardly cured and especially if the Face be ful of Pustules and as it were exulcerated and for the most part it accompaninieth the person that hath it so long as he liveth The Cure Now this Affect is not any other way to be cured but by taking away the fault of the blood and what is amiss in the Liver For albeit that the containing cause as we cal it of this Malady may be dissipated in the Face yet notwithstanding it wil not be long ere there be made a new and fresh supply of the same matter And therefore there must not only be an evacuation of the blood and the cholerick humor which for the most part is mingled together with the blood and Cupping-glasses with scarification oftentimes fastened and affixed unto the Shoulder-blades but especially and in the first place the extream heat of the blood and liver is to be brought unto a due and fit temper and the obstructions of the Liver are to be opened touching which we have sufficiently spoken before in the third Book of our Practice Part 6. Sect. 1. Chap. 1. touching the hot distemper of the Liver and there likewise Chap. 2. of the obstruction of the Liver Those Medicaments that are made and provided of Strawberries Cichory and whatsoever Compositions that have in them any of the said Cichory are here most useful and proper As for Topical Remedies let them be cooling when the Face is only red and not yet defiled with Pustules but if with the redness there be also Pustules accompanying it then the Medicaments ought likewise to be such as have in them a power and vertue to discuss Now these Remedies are administred in the form of Waters and Liquors as also of Liniments and Unguents As first thus Take the Root of Solomons Seal three ounces Flowers of Elder of the Valley Lilly of the bitter Mushroms of each six ounces white Tartar an ounce and half white Wine a pottle Camphire two drams Let them stand infusing in the Wine ten daies and afterward destil them Take Wheaten Meal as much as you think fit Goats Milk one quart make hereof Dough and making it into Loaves bake them in the Oven and let this Bread be again macerated in Goats Milk for the space of twelve hours After this add the Whites of twenty Eggs Camphyre one ounce burnt Allum two ounces Destil them and make a Water Or Take Strawberries a pint Goats Milk a quart the Whites of twenty Eggs the Seed of Quinces two ounces Camphyre two drams Allum and Sulphur of each half an ounce mingle and destil them Lac Virginis as they cal it is likewise very good for this purpose made of one part of Litharge and three of Vinegar But this following is more efficacious Take Litharge half an ounce Vinegar four ounces let them boyl to the consumption of the third part and in another Pot boyl of Salt and Allum of each half a dram Frankincense one scruple Rose water half a pint Mingle both these Liquors and pass them through a Linen strainer and keep it for your use Or Take Sulphur two drams common Salt and Camphyre of each half a dram Ceruss and Litharge of Silver of each two drams make them into a Pouder and then mingle them carefully with the Water of Bean flowers Rose water white Lilly Water the Water of Solomons Seal of each two ounces Mingle them c. Or Take Camphyre one dram pour unto it into the Mortar by a little at once and stirring it wel about of the Oyl of sweet Almonds three drams afterward pour thereunto of the Oyl of Tartar by draining two drams and then moreover add of the Yelks of two Eggs and mingle them wel together After this add of Saccharum Saturni or Sugar of Saturn half a dram mingle them with al possible care and then at the length pour in unto al the aforeâ—â—d by a little at once the Water of Bean flowers of white Lillies and of Strawberries of each two ounces and so mingle them al wel together Or Take Litharge one ounce Allum three drams Ceruss half an ounce Vinegar two ounces the Water of Roses and Plantane of each four ounces boyl them until a third part be wasted away then strain them and to the straining add a little of the Juyce of Lemmons and with this mixture let the Face be anointed in the Evening Or Take the Kernels of Peaches clean peeled bitter Almonds blanched of each in number six beat them wel in a Mortar with a little milk and then let their milky Juyce be pressed forth unto which add of burnt Allum as much as a Nut. Afterward take of Quick-silver as much as a great Pease in quantity which together with Spittle shake wel and stir it about in the Mortar until it become black and be as it were mortified and then mingle it carefully with the former Liquor with which about bed-time let the Face be anointed and then in the morning following let it be washed with Rose water or the Water of Bean flour Or Take the whitest Tartar Allum and Nitre of each four parts Sulphur one part bruise them wel and then Calcine them and in a Cellar from them make an Oyl per deliquium as they speak or by draining Or Take Kernels of Peaches hulled four ounces the seed of Gourds peeled two ounces let them be bruised and then the Oyl pressed out of them with which let the Face be wel anointed both morning and evening and afterward washed with Rose water and Bean flour Water and the Water of Solomons Seal Or Take Camphyre Litharge burnt Allum of each half a dram live Sulphur a dram and half White Vitriol and Frankincense of each one dram let them be poudered and carefully mingled with Rose water and Bean flour Water Or Take Live Sulphur one ounce Choice Frankincense three drams Myrrh two drams Camphire one dram Ceruss half a dram Pouder them al very smal and pour thereto of Rose water one pint mingle them and when the Patient goes into his Bed let his Face be anointed with the said Liquor and the morning following let it be washed with the water of the infusion of Bran. Or Take Oyl of Tartar one dram Sulphur two drams Camphire half a dram Ceruss and Litharge of each half an ounce Rose water as much as wil suffice and so let them stand in the Sun in a Glass close stopped Or Take one whol Egg and put it into the strongest Vinegar for four daies until the shel be softened afterward take forth the white and fill it up with Frankincense Mastick and Ceruss of each one dram mingle them c. Chap. 32. Of Crusta Lactea Achores Favi Tinea Ficus Helcydrium Psydracia and
Wether-Sheeps Feet adding thereto a smal quantity of Vinegar Afterward let them be wel bruised together and then pass them through a hair sieve and then add of Wheat flour and the flour of Lupines of each half an ounce the fat of an old Sow Ducks fat and Goose fat of each two ounces the Dregs or Lees of the Oyl of white Lillies three ounces and so make a Cataplasm Ganglia and Nodi may likewise be taken away by Section Section such alone of them that consist in the Head the Forehead and other places without the Joynts But those of them that consist in the Joynts are not safely to be cut there being cause to fear lest that the Nervous parts that lie underneath be hurt thereby and so consequently the motion of the Member quite taken away As in like manner it is not fit to cut those Ganglia that are neer about the Jugular Veins for fear of an Hemorrhage or flux of blood Now for the manner of Section it is this First of al there must be made a smal Wound in the Skin even unto the bladder wherein the matter of the Tumor is included through which a Probe of the thickness of a finger and round at the end but hollow in the midst is to be conveyed in betwixt the Skin and the bladder and then to be drawn about even unto the very Root of the Ganglium and then after this upon it the Skin is to have an Incision made therein deep enough in the form of the letter X and from the corner of the Bladder it is to be drawn along towards the Root and if there arise any Hemorrhage from the thicker Vessels upon their being cut about the Root it is in a fit and convenient manner to be stanched and stopt and then upon this the whol Tumor together with the Membrane is to be extracted and drawn forth and no part thereof to be left remaining behind or if haply there should be any thereof left behind it is then to be consumed with Caustick Medicaments Callous or Boney Nodi by Platerus so termed in special are hardly cured and not at al if they be inveâ—erate and hardened Such of them as are curable are to be cured by those or such like Emollients as were even now propounded Here likewise those Cataplasms are very useful that are made of Mandrake Root the Leaves of Hemlock Henbane the dead Nettle boyled in Vinegar and mingled together with Emollient Greases If these Nodi tend towards the Joynts and so hinder their motion and have their abode in those places that are naked and only covered with the Bones then the Skin is to be opened and with a sharp Iron the Nodus by a continued stroke is to be cut away from the Bone and the Wound is then to be cured in a fit and convenient manner Ganglia in special so called or those Mushrom-like spungy Tumors that arise about the Joynts and especially the Knees somtimes wholly comprehending it and hindering its motion are not to be cured without much difficulty For Section in regard that it cannot be administred without hurting the Tendons Ligaments and Nerves hath here no place And therefore we ought to assay that by Emollients and Digestives they may be discussed but yet notwithstanding we ought evermore to beware that there follow not any suppuration hereupon which in these places is wont to excite incurable Ulcers by which the Nervous parts neer about the Joynts are corrupted In this case the Medicaments before propounded are likewise very useful and profitable Or else let a Fomentation be provided of the Roots of Marsh-mallows white Lillies Briony the wild Cucumber Sowbread the Leaves of Mallows Marsh-mallows dead Nettle Henbane Ground-pine Sage Primrose the flowers of Camomile Elder Wall-flowers Melilote Linseed Fenugreek seed Bayberries Or Take the Kernels of Wallnuts three ounces the meal or flour of Lupines one ounce and half the pouder of Flowerdeluce Root and Earth-worms of each an ounce Honey as much as wil suffice and make a Cataplasm Or Take Ship-Pitch two ounces dissolve it in the Oyl of Earthworms and the Oyl of Flowerdeluce of each one ounce and half and then ad thereto of Ladanum and Mastick of each two drams Bdellium and Styrax Calamite of each one dram the pouder of Earthworms half a dram mingle them c. The Diasulphur Emplaster of Rulandus is likewise here very useful and of singular benefit but especially and in the first place Natural Sulphury Baths Chap. 35. Of Meliceris Atheroma and Steatoma THese kind of Tumors have this one thing proper and peculiar unto them to wit That the matter that is contained in them is shut up in a peculiar Tunicle or little Bladder And they take their name from the matter contained in them For if the matter that is shut up within be like unto Honey it is then called Meliceris and the Latines usually cal it Mellifavium if it be like to Frumenty which the Greeks term Atheria we then cal it Atheroma and lastly if it be like unto Suet it is then by the most called Steatoma Meliceris what it is For Meliceris as it appeareth out of Galen in his fourteenth Book of the Method of Physick and Chap. 6. and out of Aetius Tetrab 4. Serm. 3. Chap. 7. as also out of Paulus Aegineta in his sixth Book Chap. 36. and lastly out of Celsus in his seventh Book and Chap. 6. is a Tumor without pain containing a matter like unto Honey that is shut up in a little Nervous Skin Atheroma what it is But Atheroma is a Tumor without any pain containing in a Nervous Tunicle a Humor like unto Prumenty or a Pultiss steatoma what it is And Steatoma is in like manner a Tumor containing within a peculiar Membrane a Humor like unto Suet. But now touching Meliceris it is here to be noted That it is a Disease not one and the same with Meliceria of which Aetius maketh mention in his fifth Book and Chap. 28. but a disease different from it For Meliceria as Celsus himself hath it is a kind of Ulcer that is so called from the resemblance it hath with a Bee-hive which said Disease we have already explained in the secund part and Chap. 3. of Infants Diseases and by others it is likewise called Kerion Favus or Bee-hive and it is an Ulcer that is very ful of holes chiefly peculiar unto the Head pouring forth at those holes a corrupt matter like unto Honey and it hath its original from flegm that is salt or nitrous But Meliceris touching which we are here treating without any hole at al in whatsoever part of the body it happeneth to be it containeth within under a Nervous Membrane a substance like unto Honey The Causes Now all these Tumors are referred unto the Pituitous or Flegmy and they are vulgarly said to be excited from a Pituitous or Flegmy humor which in progress of time is by degrees and slowly changed
Scrofulae that are in Swine which we call the Swine pox The Breath stinketh the Voice is hoarse shril and obscure by reason that the Lungs and the parts serving for Respiration are filled and beset about with thick adust humors and by reason also of the driness and roughness of the Trachaea Arteria or the great rough Artery In the Hands the Muscles are extenuated especially between the Thumb and the fore Finger for whereas those Muscles are naturally lifted up into an hilly and manifest swelling the depression of them and their being emaciated happening by reason of the defect of aliment becomes the more manifest and remarkable in them the Nails are cleft there is present a stupidity and want of feeling in the Ankles and the Calves of the Legs and in the Feet also so that although the sick Persons shall be pricked with Pins or Needles in those places yet they feel it not in regard of the vitious matter filling up and obstructing the part hindering the access of the spirits The same likewise somtimes befalleth the Fingers and Toes in the which there is also perceived a coldness and a certain privation of al sense and feeling and somtimes likewise that stupidity and sleeping as they cal it chanceth unto the whol Skin between those Fingers and extendeth it self even unto the Arm from the Foot it extendeth it self even unto the Knees the Thighs and the Hips yea moreover the sense of feeling is diminished throughout the whol body in Elephantiack Persons For all the Nerves and Pores being obstructed and in a manner shut up by the thickness of the humors will not allow and afford any passage unto the Animal Spirits In some certain places under the Skin there is perceived and felt a kind of stinging such as is caused by Emmets or Pismires as if Nettles were rubbed thereupon and likewise a certain kind of itching and tickling as if there were Worms creeping there and this is by reason of the adust fumes and burnt vapors ascending up under the Skin The Skin it self is wholly Unctuous and Oyly so that Water poured upon it wil hardly stick and abide by reason of the melting of the fat under the Skin and the effusion of fat excrements thereinto Others there are that unto these signs add other signs also They advise us to take some few grains of Salt and to cast it upon the Blood because that if the Blood be infected the Salt is presently resolved and melted but on the contrary if the Blood be not infected They command us likewise to cast this Blood into the purest and clearest Water and if it swim at top it is corrupted but the contrary if it sink to the bottom Others there be that take the Blood and putting it in a clean Linen Cloth they wash it for if there then appear in it certain blackish rough and as it were sandy bodies it argueth a leprosie But there are other signs also of this Malady and indeed there is scarcely any evil mischief or inconvenience that is not annexed thereunto and in the which there is hardly any thing within or without that is sound But yet notwithstanding the Face is especially to be considered neither is any one rashly to be accounted Leprous unless the figure of the Face be corrupted And therefore since that in some Common-wealths there is instituted and appointed an Annual Examination and Search in and about these Elephantiack persons and that this is the chief if not the whol business of the Physitian he ought therefore to use the utmost of his endeavor and to be very cautious that through imprudence or by a rash and precipitate Judgment he do not cause such to be exiled and banished from al society that are not infected with this Disease and on the other hand for those that are infected therewith that he do not permit them to live and converse with such as are sound to the great endangering of them And this he may easily do if he have in his eye al the signs before recounted and mentioned and if he wil likewise but duly weigh and consider which of them are proper unto them and inseparable from them and what they have common with other Diseases In the serious examination of al which Franciscus Valeriola hath taken extraordinary pains in the sixth Book of his Enarrations Enarrat 5. the Reader may do wel to consult the place alleadged We must not here also pass by in silence that which Marcellus Donatus hath in his first Book of the History of things wonderful in Physick Chap. 4. by which we have occasion given us to think and conjecture how great the corruption of the blood may possibly be in those that are Leprous Annibal Pedemontanus saith he having been for two yeers vexed and afflicted with an incurable Lepra he was at the end thereof taken and surprized with a Pleurisie and having a Vein opened this strange thing befel him the hot Vrine that came from him being in quantity more than the pot could wel hold and upon which there swam a blood at least six ounces in weight so soon as it was cooled was by the said blood thickned in such a manner just as if the water had been Milk and the blood the Curd thereof so that in its consistency it seemed to be very like unto curdled Milk yet still retaining its own proper color of the which there was not one drop indeed to be found that was severed from the rest and not curdled The cause hereof is given by the Author before cited who conceived it to be and imputeth it unto the thickness and clamminess of the blood which being throughly mingled with the Water the actual heat of both of them assisting and furthering the distribution in their mingling together when it had abated of its great heat and was now become cool gave the occasion of the said coagulation or curdling And he conceiveth likewise that here the very same thing happened that cometh to pass when the smal parts and pieces that are cut from Hides and Skins are boyled in Water for the making of Glew For so soon as ever that Water is cooled it instantly is thrust and forced close together by reason of the clamminess and sliminess of the juyce and the like also happeneth in some kind of meats that we eat that are made of Calves feet and the feet of other living Creatures Prognosticks 1. By al which iâ— appeareth That this Malady is most grievous and dangerous hard to be cured and the truth is not at al curable unless it be taken in hand in the very beginning and first rise thereof neither then without much ado and difficulty For an Elephantiasis inveterate and confirmed wil at no hand admit of any Cure For if a Cancer being but a particular disease only wil allow of no cure how much less wil the Elephantiasis that is an universal Cancer of the whol body admit and receive any And
Part 4. chap. 4. of the Inflation of the Liver ibid. Part 6. Sect. 1. chap. 3. of the Tympany ibid. Part 6. Sect. 2. chap. 4. of the windy Rupture ibid. Part 9. Sect. 1. chap. 7. of Satyriasis and Priapismus ibid. Sect. 2. chap. 3. of the Inflation of the Womb Book 4. chap. 10. of the Inflation of the Head Tract of Infants Diseases Part 2. chap. 6. Touching those Tumors that arise from the soft parts when they are removed out of their own proper places we have likewise spoken of them in special and first of all of the falling down of the Vvea in the first Book Part 3. Sect. 2. Chap. 25. of the Hernia of the Intestines Book 3. Part 2. Sect. 1. Ch. 6. of the Umbilical Hernia ibid. p. 10. Ch. 2. of the falling forth of the Womb and the Uterine Hernia B. 4. Part 1. Sect. 2. Chap. 16. and 17. And moreover as touching the Scorbutick Atrophy Of the Atrophy in general we have written sufficiently thereof in its proper place But now whereas we have in the general spoken of the augmentation of magnitude in the whol body and in general above Chap. 4. those things therefore which may in general be further spoken of the Atrophy we think it nor amiss to subjoyn them here in this place When the Body is not nourished so much as it ought to be Certain peculiar Species of an Atrophy but is diminished and lessened by reason of the denying of food unto it this may indeed in the general be called an Atrophy But yet notwithstanding the peculiar Species of an Atrophy have likewise their peculiar names That which proceedeth from the Ulcer of the Lungs is properly called Phthisis and Tabes that is from an Hectick Feaver is named Marasmus and Marcor And that which happeneth without these causes is called in general an extenuation of the Body We here in this place use the word Atrophy in a general signification and under it we will comprehend all and every preternatural Extenuation of the Body by reason of the defect of Nutriment But now an Atrophy is twofold Atrophy in general what it is the first is of the whol Body the other of some one particular part as of the Arm the Foot c. The Atrophy of the whole in general so taken is a preternatural extenuation of the whole Body by reason of its being frustrated of its food and its being denied its due and requisite Nutrition The Causes As touching the Causes of an Atrophy this in the first place is to be taken notice of viz. that the Cause that invadeth the whole body is either in its own quality and disposition according to Nature or else it is preternatural And then likewise that which is Natural or according to Nature is the Marasmus as we cal it in old age and in aged Persons For there was never yet that living Creature born or brought forth than was not obnoxious to old age and which in old age did not wither and consume away But since that this Atrophy cannot by any Art whatsoever be prevented we wil therefore in this place speak only of that Atrophy which happeneth preternaturally unto some Bodies alone and not unto all in general But now whereas there are two things that concur and are necessary unto Nutrition 1. By reason of the Nutriment to wit Nutriment and the nourishing faculty in both these likewise the Cause of Nutrition diminished and consequently of an Atrophy is to be sought after In regard of the Aliment the body consumeth and wasteth away by reason of its either defect or vitious quality which we may cal its pravity For if there be not dayly as much of this Aliment again taken into the body as is every day insensibly discussed then the body wasteth But if there be indeed a sufficient store and stock of blood treasured up in the Veins yet notwithstanding this is vitious and naught and either it is not at all attracted by the parts or if it be attracted yet can it not be assimilated The body is extenuated and pineth away in the defect and want of Food and Nutriment when in place of that Substance that is dayly wasted and diffused by an insensible transpiration and exhalation there is no other Nutriment or at least not a sufficient store thereof substituted and supplied Now whereas the blood is the proxime and nighest Nutriment of the whole body there the Nutrition is especially hurt through the defect and failing of the blood Now the blood faileth first of all in regard of some default and error in the first Concoction when there is not a sufficient quantity of Chyle from whence the blood ought to have its original generated and bred in the Stomack and this may happen unto such as are sound and in perfect health by reason of a dayly and continued scarceness of Food and their frequent spare Diet but it happeneth in such as are sick and unhealthy when by reason of the want of appetite it being now much dejected and weakned they are averse from all kind of Food and refuse to make any or else when by reason of their Disease they are fed with but little Food and that likewise not much nourishing Which may also happen if the Food that is taken in be presently sent and driven down into the Guts either Crude or Raw or else turn'd into Chyle and so is by the Belly ejected without its ever coming unto the Liver The same may likewise happen if by reason of any Disease whatsoever in the Stomack its Concoction being thereby much weakned the Chyle that is generated be either but little in quantity or that which is as bad or worse imperfect and not sufficiently elaborated Moreover Nutrition may be hindred because of the hurt of the sanguifying faculty to wit when by reason of something amiss in the Liver or Spleen the blood that is generated is impure and not good and this cometh to pass in the Cachexy Leucophlegmatia Tympany the Dropsie Ascites the Scorbutick atrophy and the long lasting Scabbiness Now as for the Causes of Sanguification they have been already in the third Book of our Pract. mentioned and explained From whence it happeneth that albeit there be a sufficient quantity of Food taken into the body yet notwithstanding there followeth no Nutrition and this again happeneth for two Causes to wit because either there is no aliment appointed by Nature for the nourishing of the parts or if there be any appointed for this purpose yet notwithstanding it cannot be rightly assimilated There is no aliment appointed unto the parts either because the Chyle is not so exactly elaborated in the Stomack that it may be converted into good blood or else because although the Chyle be sufficiently and rightly elaborated in the Stomack yet by reason of some fault in the Liver it is not converted into good blood or else because that although there be Chyle generated
order following to wit 1. If we first of all treat of a simple Ulcer or an Ulcer considered in the General 2. Of an Ulcer with a Distemper 3. Of an Ulcer with an afflux of humors 4. Of a sordid and foul Ulcer 5. Of an Ulcer with Tumors 6. Of Flesh growing forth luxuriant and proud 7. Of an Ulcer that is wan or Leaden coloured and withall Callous 8. Of an Ulcer that is hollow and fistulous which we commonly call the Fistula 9. Of an Ulcer with Worms 10. Of an Ulcer with a rottenness of the Bones 11. Of the Ulcer by the Greeks called Dysepulot Malignant the Ulcers Telephia and Chironia and Phagedaena 12. Of pain with an Ulcer 13. Of the Ulcers of the Legs and other parts 14. Unto which we wil add something touching Burnings 15. We wil conclude all with a short Discourse touching a Gangrene and Sphacelus Chap. 2. Of a simple or single Vlcer IN the first place therefore we wil handle a simple Ulcer and shew you what are the Causes of an Ulcer considered in the general and what differences it hath according to its form its causes and the place affected by what signs the Ulcer and its essential differences may be known and what is to be pre-advised as touching the cure and what the Ulcer in general indicateth and pointeth out and lastly what kind of Method and course it requireth for the curing of it The Causes We have already told you in the precedent Chapter that the neerest cause of an Ulcer is a matter that hath in it a corroding quality whether it be bred in the Body or whether it happen unto the body from without Of the first sort are al Humors whatsoever that are sharp and endued with a corroding Faculty bred in the body But now this humor is either bred without the part affected or else it is generated in the very part it self that is affected Without the affected part there is generated a cholerick humor a salt flegm a Whey that is salt nitrous and sharp and black Choler or Melancholy For these if they be bred in the body and flow unto any one part they may corrode and exulcerate the said part But from what Causes such like humors may be generated in the body we have already shewn you in the second Book of our Institutions touching the causes of Diseases and elsewhere Now they flow unto the part affected either by transmission or by attraction both which from what causes they proceed we have declared above in the first Part and Chap. 5. of an Inflammation And more especially in the Spring time various Ulcers are wont to arise from some internal vice of the Humors as likewise from unseasonable and immoderate exercises For if as Galen writeth in his third Book upon the Aphorisms Aphor. 20. in the Spring the Body be impure there happeneth indeed then some such like thing in the Spring time even as we see there is wont to be in the exercises of the Body For although these exercises be never so safe and healthful in themselvs yet nevertheles if you bring forth a man that is full either of flegm or yellow choler or black choler or even also of blood it self to exercise you shal undoubtedly by this exercising of him procure unto him either the Falling-sickness or the Apoplexy or if not these yet most assuredly the rupture of some Vessel in the Lungs or a most acute and violent Feaver But unto such as have had exercise enjoyn'd them for the purging out of humors that lie low and deep this their exercise drawing forth unto the skin a Gacochymy that is to say abundance of bad and offensive humors and scattering it throughout the parts doth for the most part excite and cause Vlcers and the Scabies or Scabbiness For this is that which Hippocrates hinteth unto us when he saith That if we exercise an impure and impurged body Vlcers wil from thence arise And so indeed in the very like manner in the Spring time the heat of the ambient Air dissolving the humors calleth them forth unto the skin by an effect altogether like unto that of exercises For the effects of the Spring do not only resemble the effects of Exercises but they are also most like unto the works and operations even of Nature her self For indeed the parts that the Spring time acteth like as doth Nature her self are as wel to cause that occult and secret perspiration throughout the whol body by the which all the superfluities of the body are emptied forth as throughly to purge the body also by diseases after a various and different manner Thus â—aâ— Galen But then these Humors get their acrimony in the part it self by reason of some distemper in the said part And after this manner like as even the Pus or puâ—â—lent matter it self by its concoction and long abode in the part becometh more sharp and stil so much the sharper and corroding by how much the humor out of which it is generated is more tart and sharp so likewise doth the blood which is corrupted by the part affected and so putrefieth But now the Causes that happen unto the body from without are Septick or putrefying and Caustick Medicaments Neither do I here exclude the very actual fire it self from bearing a part in the number of the external causes in regard that the Eschar that is left remaining appertaineth rather unto ulcers than unto wounds And hither likewise is to be referred that contagion by means whereof the vapors exhaling from the Lungs of Phthisical persons by others attracted drawn in with the breath do likewise exulcerate their Lungs and so cause in them a Phthisis or Consumption and also the nastiness and infections of such as are scabbed Leprous and affected with the foul Disease being communicated unto the skin do exulcerate it and there generate a like disease But that attraction which is caused in gauling interfairing or in wearing of the skin by the wringing and streightness of the shoo is not rightly and fitly referred unto and reckoned up amongst the nighest and most immediate Causes For by the said attrition the humor only is attracted that afterwards corrodeth the Skin and exciteth therein little bladders or blisters But now what the special causes of special Ulcers are we shal afterwards shew you in its proper place where the peculiar causes of each particular Ulcer shal be explained of the Ulcer cannot be filled up neither can there flesh enough grow forth from whence it is that an hollow Cicatrice is caused 19. If the Ulcer after such time as it is filled up with flesh and that a Cicatrice ought to have been brought thereupon wax crude and raw again there is then great cause to fear that the Ulcer wil turn into a Fistula 20. Ulcers that are in the Feet and in the Hands are wont somtimes to hasten on Inflammations of the Glandules in the Arm-pits or in the
the flowing humors such is likewise the diversity and variety of the Tumors that are excited to wit an Inflammation an Erysipelas Oedema and Cancer But what humors they are that excite those Tumors hath been above declared where we spake of Tumors Signs What kind of Tumor this is and what danger it produceth and threateneth appeareth likewise sufficiently from the places alleadged neither is there any need at all that we repeat any thing here of what was there said The Cure The way Means and Method of Curing it was there likewise declared which is yet nevertheless here in such manner to be instituted that the Ulcer may not in the least be neglected If therefore either the Blood offend in its quantity and overgreat abundance or else if vitious humors abound in the body these are first of all to be evacuated In the next place regard is to be had to the very part affected After this Medicaments are to be applied unto the place affected which may either discuss the humor that is the Cause of the Tumor or else convert it into Pus And therefore in an Inflammations there ought to be applied a Cataplasm made of Quinces boyled with the Pouder of Myrtle or of boyled Lentiles with the Meal or flour of Barly Pomegranate rinds and red Roses In the augmentation of the Ulcer there must be added Camomile flowers and Bean meal In the State Mallows Marshmallows the meal of Linseed and of Fenugreek As Take Barley meal two ounces the pouder of Camomile flowers one ounce the meal of Linseed and of Fenugreek of each six drams and make a Cataplasm If the Tumor tend toward a Suppuration the Suppuration is then to be holpen on with a Cataplasm of Mallows Mashmallows Linseed Fenugreek and Wheat and other such like Ripeners As Take Mallows Marshmallows of each one handful boyl them in Water until they be soft and then bruise them well When they are bruised then add of the flour of Linseed and Fenugreek of each one ounce Wheat flour half an ounce Swines fat and Oyl of Roses of each one ounce and Mingle them If an Erysipelas be joyned together therewith externally and in the neer adjacent places those Medicaments are to be imposed that we have above propounded in the first Part and Chap. 7. touching an Erysipelas There is here very usefully imposed upon the external parts the water of Elder flowers and Night shade We add this only that somtimes it so happened that as in an Erysipelas if it be not rightly Cured and if such things shal be rashly and unadvisedly administred that obstruct the Pores so that the humor can by no means pass forth nor be dissipated or that there be caused an over great asslux of humors Pustules oftentimes yea and greater blisters and bladders are excited in the affected part out of which when they are broken there issueth forth a warry Sanies and the part is afterward exulcerated and unless it be rightly handled the Affect soon degenerateth into long continuing and malignant Ulcers especially in the Thighs yea and oftentimes into a very Gangrene it self Which if it should change so to happen it wil then be very requisite to make use of Coolers Driers and Astringents together As Take Platane Leaves one handful flowers of red Roses half a handful boyl them to a softness and then let them be bruised when they are bruised and passed through a Hair-sieve add of Barley meal one ounce and half the pouder of Pomegranate flowers half an ounce with the oyl of Roses make a Cataplasm That that is here especially useful and profitable is the Unguent Diapompholyx unto which if you please you may yet further add some Sugar of Saturn If the Tumor be cold then such a like Cataplasm as this may be imposed Take the Leaves of Mallows Marshmallows of each one handful and boyl them in Ley unto a softness and then bruise them wel then add the pouder of Marshmallow root one ounce and half Camomile flowers ten drams Oyl of white Lillies as much as wil suffice and so make a Cataplasm If a Cancer be joyned with the Ulcer there can then be no other Cure more fit and proper then that we have already propounded touching an ulcerated Cancer The rest of what might here be spoken touching these may be seen if they be sought for in the first part touching Tumors Chap. 7. Of proud flesh growing forth in Ulcers IT happeneth oftentimes that in Ulcers there is found proud flesh and such as groweth forth further then what is fitting which Malady the Greeks term Hypersarcosis which whensoever it happeneth it hindereâ—h that the Ulcer cannot possibly be shut up with a Cicatrice The Causes Now this happeneth either from the abundance of blood that floweth unto the part affected or else by reason that the Sarcotick Medicaments that had been administred were overweak and less drying then what was fit If the former of these be the Cause then the flesh it self wil be in a right temper only there wil be too much thereof If overmuch flesh proceed from the latter of the two Causes then the flesh wil not be sound and solid but loose and Spungy The Cure As for what concerneth the Cure if the first happen fasting and spareness of Diet is then to be enjoyned unto the sick Person and dry Medicaments are to be imposed But if the flesh begin to grow proud by reason of the use of Sarcotick and detersive Medicaments that were in their own Nature overweak then we ought to make use of the stronger sort of Detersives and such as produce a Cicatrice and if there be occasion even septick Medicaments likewise And such are a Spunge burnt dry Liniments imposed the rind of Frankincense Galls Aloes Tutty and burnt Alum And indeed in the Toes when by reason of the compression of the excrescent Nails the flesh beginneth to be luxuriant so that a man can neither put on his Shoes not go without pain then burnt Alum alone sprinkled thereon wil take away the said flesh The stronger Medicaments are the rust and scouring of Brass Chalcitis Mercury precipitate Mercury sublimate And therefore whensoever there is need but of litttle drying then let there be imposed dry Liniments or else such as have been soaked and wel wet in this following Decoction Take Galls the rinds of Frankincense and Mastick of each one dram Flowers of red Roses Pomegranate flowers and Rue of each half a handful Alum two drams boyl them al in Wine Or Take Galls Pomegranate rinds a Spunge burnt of each alike and make a Pounder to be strewed thereon There is more especially useful this green water following which being besprinkled upon the luxuriant flesh or else imposed thereon by Liniments it taketh away the said flesh without any pain at all and generateth a Cicatrice The Green Water Take Alum Crude and Green of each two drams boyl them in eighteen ounces of Wine until a fourth part be wasted
likewise by evacuating and emptying forth of the peccant and depraved humors either by opening a Vein or by purging Medicaments if need require and that the nature of the Disease and the strength of the Patient wil bear it but we are here alwaies to take heed how we give those things that are too strong the Malignity is to be expelled and the depraved matter to be driven forth from the more inward unto the external parts and such a like Cure almost is here to be instituted as is wont to be in malignant Fevers to wit there are Medicaments to be administred of Citrons Sorrel Roses Borrage Water Germander Carduus benedict Dittany of Crete Swallow-wort Angelica Treacle likewise and Mithridate And we must do our endeavor that a Sweat may be provoked by these medicaments and that the Poyson may be driven forth from the Noble members unto the exterior parts Which that it may the more successfully and more easily be done the malignant matter is likewise by Topicks to be drawn forth unto the external parts Where we are also to take notice that if poyson stick outwardly unto the body as it happeneth oftentimes from the strokes of poysonful Creatures then Defensives are to be administred lest that the Poyson creep broader and spread it self unto the more interior and Noble parts But if the malignant matter be bred in the body then Defensives are by no means to be administred but the said Matter is only to be called forth unto the external parts unto which end Scarifications may be administred unto the part affected Cupping-glasses likewise and Leeches may be applied and moreover the part also may be washed with the Decoction of those Medicaments that resist malignity and putridness such as are Wormwood Rue Dittany Asclepias or Swallow-wort Angelica and especially Water Germander which is of a most soveraign virtue in all Gangrenes and that that hath in it an extraordinary power to preserve from putridness And others there are that to attract do make use of the Raddish root the Seed of Cresses and the like But if Poyson shal chance unto the body from without and shal either by a blow biting or any other touch be transufed into the part affected then those Medicaments that do strongly attract the Poyson dry it up and consume it are to be made use of for which end and purpose an actual Cautery may most fitly be administred The part affected being either scarified or burnt then there are further to be applied those Medicaments that resist putridness and prevent the Necrosis or Mortification and such as do also attract and draw the offensive and depraved matter as an Emplaster of the aforementioned Medicaments with which we may likewise mingle Leven and Garlick roasted in the Embers And at length the Gangrene being in a fair way of recovery if there hath happened any Ulcer from the scarification or burning it is then to be cleansed by Medicaments of the Juyce of Smallage and Honey of Roses unto which if need be there may be added some Spirit of Wine and other things are moreover to be done that are fit and convenient for the Ulcer A Gangrene from Inflammation Thirdly The Gangrene that is wont to follow upon great Inflammations and to arise from the abundance of blood and humors that suffocate the Natural heat of the part is cured in this manner First of all the Diet that is appointed ought to be slender and such as is cooling The blood and humors that flow overmuch into the part are to be emptied forth of the whol body by opening of a Vein Scarifications Cupping-glasses Purgers and other convenient Remedies and lest that they should any longer flow into the affected part they are to be drawn back and derived unto some other place and round about the part affected there is some kind of Defensive to be applied as we told you above in the first Part Chap. 5. touching an Inflammation And then immediately the blood and humors that are corrupted in the part and suffocate the Native heat are to be evacuated out of the part affected that so the cause may be taken away and the former heat and vigour may be restored unto the Member Wherefore the part must presently since that there is danger in delay and the blood that hath already begun to be corrupted by reason of its abundance and thickness can hardly be digested or dissipated by Medicaments be scarified with many sections and these ought to be made deep enough and of the corrupted blood a sufficient quantity to wit great store and plenty thereof is to be evacuated And yet nevertheless in the greatness and depth of the Incisions we ought to have respect unto the greatness of the Affect it self and according as the Affect is more or less nigh unto putridness and a Sphacelus so thereafter the Incisions are to be moderated Some likewise there are that apply Leeches or the lesser sort of Cupping-glasses if the blood be not sufficiently and plentifully evacuated by scarifications alone The Incision being made the part is to be washed with salt water or a Ley unto which we may likewise add Lupines or Aloes and boyl them together that so if any of the thicket blood continue yet sticking in the part it may be washed off and that the Reliques or Remainders of the putrid matter may be evacuated and al possible resistance made against the putridness And for this end this Decoction following may be made use of with the which the affected Member as often as any new Medicaments are applied is to be washed Viz. Take of the strongest Ley and of the best Vinegar of each one quart of Water Germander Lupines Wormwood bruised of each half a handful of Flowerdeluce root round Aristolochy and Swallow-wort of each half an ounce let them all be boyled to the consumption of the third part unto the streining add of Aloes and Myrrh pulverized half an ounce and then let them boyl once or twice again at length add Hooney of Roses one ounce Spirit of the best Wine three ounces Mingle them c. When the part is washed then the Aegyptiack Unguent is to be laid on which here is reputed the most excellent of all the rest as being a most efficacious Remedy for the taking away of putridness and for the separating of the dead flesh from the sound But if the Corruption be more then ordinary then Gulielmus Fabricius compoundeth such a like Remedy as this following which likewise resisteth malignity Take Rust of Brass three ounces of the best Honey and with the Decoction of Wormwood and Water Germander scummed one pint Vinegar of Squils six ounces Alum and Salt Armoniack of each half an ounce the Juyce of Rue and Water Germander of each two ounces boyl them to a good thickness and afterwards add of the best Treacle and Mithridate of each half an ounce Camphire one dram and mingle them This Water is likewise very useful if
a wollen Cloth be wee therein and so imposed upon the place affected it hath likewise been happily and successfully administred in the Gangrene of the Cods of which we have spoken above Take Vitriol one ounce the tops of the Oake one handful Frankincense half an ounce Camphyre two drams Vrine two pints and half boyl them to the Consumption of a third part and then strain them But the Aegypriack Unguent is not alone to be applied but upon the Unguent that Cataplasm is also to be imposed which resolveth drieth and hindreth putrefaction such an one as Johannes de Vigo in his second Book first Tract and seventh Chapter describeth and commendeth and which many other Physitians and Chirurgeons now a daies likewise make use of And all these are to be applied blood-warm and they are so long to be continued untill the putridness be removed But if the Malady wil not yield unto these Remedies then we are to have recourse unto those that are stronger to wit Causticks such as those Trochisques of Andro Polyidas Musa and Pafio which dissolved in Vinegar and Wine may be imposed upon the part Many indeed do here commend and prefer Arsenick before all other Remedies but Gulielmus Fabricius doth and not without good Cause reject and altogether disallow of it in the Cure of a Gangrene as that that not only hath in it a Septick and putrefying faculty and a quality of melting the flesh as it were but that likewise produceth very great and grievous Symptoms vehement pain Dotings Syncope's and the like the malignant vapours being communicated unto the principal part It is therefore more safe to make use of an actuall Cautery as that which hindereth and preventeth putridness drieth and corroborateth the part This is also much commended Take Mercury dissolve it in Aqua fortis when it is dissolved precipitate it the Oyl of Tartar after it is precipitated wash it Or Mercury alone dissolved and mingled with the Water of the Trinity Flowers and wollen Cloaths wet in this Liquor may be imposed on the part The Crust in what manner soever it be produced is to be taken away by those Medicaments that have been above declared in the first Part and Chap. 13. touching a Carbuncle Neither are we to wait so long til Nature shal altogether have separated the Corrupt from the Sound but the highest part of the Crust is with the edge of a Knife or a Penknife to be cut even unto the sound part that so there may be a way made for the Medicaments unto the deeper parts and the rest that are corrupted For if we expect until the Crust shal be freed of its own accord it may possibly happen that under the Crust a new putridness may be contracted The rest of the Cure is in the same order to be proceeded in as is fit to be done in Ulcers Fourthly If the Gangrene happen from overmuch heat A Gangrene from too much heat then a Cold Diet being prescribed and the hot humors being duly qualified and evacuated if the Malady take its original from an internal Cause the Member affected is to be scarified and then washed with such a Decoction as this Take the Water of Endive Sorrel Lettice Nightshade and Vinegar of each one pint Syrup of Sorrel two pound of Lupines half an ounce Water Germander half a handful Salt three ounces boyl them till a third part be consumed After this the Aegyptiack Unguent and the Cataplasm but even now mentioned is to be imposed and the rest which were before prescribed are speedily to follow Where notwithstanding this is to be observed that unless in case of urgent necessity we must not have recourse unto the actual Câ—utery lest that hereby to wit by the power and force of the fire the extraneous heat which is the Cause of the Gangrene be augmented Fifthly and lastly If the Gangrene arise from the defect of Aliment and Blood and Spirits A Gangrene by reason of an Atrophy in the part and chiefly in truth if it be by reason of a Driness and an Atrophy necessaâ—ry Nutriment being denied unto the part then meats that are hot and moist easie of Digestion and such as generate much and good blood are to be given unto the sick Person and outwardly the body is likewise to be moistened with Oyntmentâ— of sweet Oyl or with Oyl of sweet Almonds and all things are carefully to be avoided that exsiccate and dry the body And unto the part it self that is already affected with the Gangrene the Aliment is by all manner of means to be attracted And therefore here there is no place left for Defensives in regard that they shut and stop up all passage of the blood and Spirits unto the part affected And therefore we are not only to anoynt the part affected and the other members with the Juyce of Earth-worms which is made of the said Earth-worms first washed in Water and then in Wine so put into a great Vessel with good store of the Oyl of sweet Almonds Violets and melted by a gentle and moderate heat over hot Embers and afterwards strained which is a sprecial and soveraign Remedy in the Atrophy and extenuation of the parts but the part affected is therwith likewise gently to be rubbed and chafed unto which also Cupping-glasses not scarified are to be applied But it wil be most fit and requisite if there be already present a putridness to administer those things that do alike both attract and resist putridness such as are Salt Water boyled with Water-Germander Liquid Pitch with the meal of Lupines of the bitter Vetch Orobus Myrrh and the like But if the Gangrene hath already made any progress the part is then to be scarified and the Aegyptiack Unguent and that likewise that is compounded of Pitch and those other things a little before mentioned are to be laid thereon A Gangrene from the interception of the blood spirits Moreover If the Gangrene happen from the interception of the Blood and the Spirits likewise whatsoever the Cause then be that thus intercepteth the blood and the spirits it is immediately to be taken away as if the said interception be from the binding of the part it is forthwith to be loosened and withal those Medicaments that resist putridness as likewise those that discuss that that is corrupted such as are those that are made of the Meal of Beans of the bitter Vetch Orobus of Lupines Aloes Water-Germander and the like are to be imposed And if the Gangrene hath already gotten unto any heighth the place is to be scarified and those other things that are required in al Gangrenes are to be done If an astringent and repelling Medicament be the Cause the said Medicament being removed the heat is to be recalled by Frictions Lotions and Anointings And so we must also proceed in the Gangrene that hath its original from other Causes that intercept the Spirits For the Cure of the Gangrene
hinder that Section that is made with the Saw that flesh is likewise to be cut off with a Knife that is fit for the purpose And then instantly and with as much speed as possibly may be the Bone is to be amputated with the Saw unless the Section be in the Joynt for then the Member may be amputated with the Razor alone The amputation of the Member being finished the next thing to be done is the stopping of the flux of blood after that it hath flown forth sufficiently Most Practitioners burn the Vessels with a Cantery But Paraeus much disliketh this course for he conceiveth it indeed to be very cruel and barbarous in regard that it causeth an extraordinary great pain if the Section be made as it ought to be in the quick and live flesh and very bad and dangerous Symptoms happen unto the Nervous parts unto which we may add that by the said burning very much of the sound flesh is consumed whereupon the bones are left bare and the flesh together with the Cicatrice either it is not at all brought over the naked part or if it be it is not without much difficulty And therefore he Practiseth another way of stanching the Hemorrhage to wit with a Crows-bil he laieth hold upon the Vessels and draweth them altogether then bindeth them as close as may be The Vessels being thus straitly tied together with a Ligature or if you judg this more fit shut up close with a Cautery the bonds are then to be loosened and the courser part of Flax or Hemp we cal it Hurds after it hath been throughly soaked in the White of an Egg and sufficiently besprinkled with a Pouder that hath in it a virtue and faculty of stanching the blood is to be laid upon the Member And yet nevertheleless for the most part without any such Ligature or Cautery the blood may likewise be stopped and stanched after this manner As Take the finest Flour three ounces Dragons blood Frankincense Aloes of each two drams Bole armenick Terra Sigillata Parget or Plaister of each one dram Water Frogs prepared though there be some that for this use and purpose do rather commend those of them that live among Trees one ounce the Flix of a Hare cut very small a thin Spunge torrefied by the Fire of each two drams and make a Pouder Upon the Vessels likewise that pour forth blood there may very fitly be applied and laid on that Mushrom so much used by Câ—iturgeons to stanch blood which they cal Crepitus Lupi Others there are that make up Emplasters of Dragons blood Bolearmenick Terra Sigilata and the finest Volatile flout and the like with Pitch Afterwards the Trunk of the amputated Member is to be safe guarded with those Defensives or such like as we have above mentioned the like unto which is this also that followeth which is to be applied with Hurds and Swathe-bands having been first wel and throughly soaked in Oxycrate Take Bolearmenick Terra Sigillata Dragons blood Mastick Parget Oyl of Roses and Oyl of Myrtle of each one ounce Whites of three Eggs Vinegar as much as wil suffice and make an Vnguent And this is the first dressing or the first binding up which is not to be loosened in the Summer time before the second or third day but in the Winter not before the fourth day at the soonest unless in case of urgent necessity And in the mean time the Member is to be placed in a direct middle posture or figure in Pillows stuffed with the hairs of Harts or Wheaten meal The first binding being loosened and the first Provision taken away again with the White of an Egg as before the Pouder stanching the blood is to be applied and the excremities of the bones to be covered with a piece of the dry Liniment and in the end the Wound to be bound up with some kind of Digestive And this Cure is so long to be continued until there be now no cause of further fear that any mischief may follow upon the Hemorrhage and that the Wound be now become Purulent For then these Medicaments being laid aside we are to make use of Cleansers Gulielmus Fabricius commendeth tins Unguent following of the Juyce of Smallage not only for the Gangrene but likewise for other sordid foul and Malignant Ulcers Take the Juyce of Smallage of Water-Germander of Waybred or Plantane and of Rue of each two ounces Honey of Roses strained one pound boyl them to the Consistence of a Syrup and afterwards mingle therewith the meal of Lupines the Pouder of round Aristolochy root of Angelica root of Swallow-wort and of Treacle of each half an ounce Aqua vitae one ounce make an Vnguent In the mean time we must do our endeavor that the Lips of the Wound may be drawn together and afterwards that flesh may cover the bones and nay be unto them in stead of the Pillows Paraeus and others saw together the lips of the wound in the form of the letter X but a Suture which they cal the dry Suture seemeth to be far more convenient or else by a Glew which is done after this manner A Linen Cloth of a convenient figure and bigness moistened throughly in a Glew of Astringent Emplastick and viscous Medicaments such as are Bolearmenick Dragons blood Gum Tragacanth Sarcocol Mastick the White of an Egg and the like is to be laid upon the place As Take Mastick Dragons blood Bolearmenick Sarcocol and the finest Volatile flour of each half an ounce Rosin of the Pine Tree two drams mingle them with the White of an Egg. Of this Linen Cloth let there be made Emplasters which are to be applied unto the extremity of the Wound on both sides So soon as the Emplasters are become dry so that they begin to stick too fast unto the Skin then we use to annex unto them little handles to hold by of Thread twice or thrice doubled and with them we contract the lips and this may likewise be done in a suture that is more thin sewed And then at length we must do to the utmost of our endeavor that the excremities of the bones which were hurt by the touch of the Iron and the Air may fal off For which end some there be that burn the utmost parts of them with a red hot Iron yet stil taking great heed lest that the flesh and other of the sensible parts be hurt thereby Others make use of the Emplaster of Becony and other Catagmatick or Fracture Medicaments And so within thirty or fourty daies whatsoever there is of the bone corrupted wil fall off If the flesh be luxuriant or proud as we sometimes term it it is then to be repressed and kept under by the Pouder of Alum and the like and at length the Cicatrice is to be brought over it But whereas pains do in the mean time much infest and disquiet the sick Person and that there is cause to fear lest that Convulsions
and the Skin it self For albeit while the place of the Itch be scratched there is perceived a certain seeming pleasure yet nevertheless this pleasure doth not belong to the Nature of the Itch but it followeth only upon the scratching whilst that the parts that were gnawn by a sharp matter do suddenly return unto their natural state and their wonted smoothness For like as there is a pain excited from that sudden motion unto a preternatural state so in like manner there is a certain pleasure felt from this sudden motion and return unto their Natural state Now the truth is the Itch it self ceaseth after scratching because that the matter which was the cause of the Itching is evacuated and because also that the solution of Continuity that exciteth the pain is again brought unto an Union and quietness if the scratching be any thing strong The Causes The neerest cause of the Itch is a salt Excrement that is biting and sharp to wit either meer pure Choler or else black Choler commonly called Melancholy or else a salt flegm Which excrement albeit that it be present also in the scabby Affect yet in the Itch it is more thin and insinuateth it self through the least particles But it sticks between the true skin and the scarf-skin and thereupon by its acrimony it goadeth as I may so say and pricketh the sensible particles in the skin and provoketh them unto scratching And indeed like as the Nature of the excremens it self maketh much for the sticking of the said Excrement in the Skin this Excrement although it be thin yet having in it a certain kind of clamminess and glewishness by the which it sticketh very close and pertinaciously unto the parts so doth likewise the thickness of the skin it self by reason of which it cannot exhale But now that excrement is collected by reason of the heat and driness of the Liver the use of sharp meats and many Spices And hence it is that old men those especially of them that in their youth had a hot Liver and such of them as then used a hot kind of Diet in their meat and drink are in their old age so sensible of the Itch and at length come to be troubled with scabbiness See further hereof in Galen his second Book of the Causes of Symptoms and the sixth Chapter The Differences Now according to the variety of the humor and the nature of the places affected there is a certain difference likewise of the Itch. For look how the matter is more or less sharp so the Itch that is excited is more or less contumacious and troublesom And somtimes there is felt an itching in the skin of the whol body and somtimes in some parts only Prognosticks 1. The Itch is for the most part the forerunner of Scabbiness shortly to follow For if the Itch be of any long continuance there is then at the length collected a greater abundance of the matter and this receiving a putridness is rendered more sharp and it corrodeth the Scarf-kin and exciteth Pustules 2. By how much the worse the humor is that exciteth the Itch by so much the worse is the malady also To wit the Itch that is excited from burnt blood or Choler is sooner ended and gone but that which proceedeth from salt slegm lasteth longer and longest of al that which hath its original from burnt Melancholy 3. The Itch in which there is great pleasure taken in the scratching thereof is evil because that it ariseth from a sharp Choler 4. The Itch in old people is seldom cured especially in those that are decrepit For since that old age is fit for the treasuring up of these salt humors that disposition of the body is hardly changed and brought unto a better state And yet notwithstanding if diligence and care be shewn it is somtimes healed And Mercurialis in his Tract of the Diseases of the skin Chap. 3. relateth that Leonellus Pius a man fourscore yeers old was freed from an extraordinary great Itch by the benefit of Medicaments 5. Hippocrates in Coacis writeth that the Itch in those that have Consumptions if it succeed the suppression and binding of the Belly is not only dangerous but deadly For by reason of the trouble and disquiet of the Itch those in Consumptions can neither sleep nor take any restr whereupon there is little or no Conconction and therefore they have their death hastened upon them The Cure The Itch seeing that it is a pain if it be extraordinary great and vehement and cause watchfulness thereby decaying the strength sheweth that mitigation by Anodynes is to be procured but the Cause that it dependeth upon calleth for evacuation And indeed the next Cause since that it is a sals humor sticking in the Skin this is likewise to be evacuated from the Skin And in regard that this said next cause is nourished by a like humor contained in the Veins therefore this is likewise to be evacuated And because that this humor is generated from a distemper and vitious disposition of the Bowels it is therefore to be anointed and so the generating of such like humors is to be prevented Those Moisteners take away the Itch that mitigate the sharp matter that is the Cause of the Itch. Now those things that evacuate these excrementitious humors from the Skin are those Medicaments that Cleanse Mollifie and make thin Purgers take away the Antecedent Cause Alterers amend the vitious disposition of the Bowels but more especially a good course of Dier And therfore in the first place the Salt Nitrous and sharp humor is to be prepared and evacuated The humor is prepared by such Medicaments as have in them a power of Cooling and Moistening and such as withall attenuate the Thick Clammy humor such as are Succoâ—y Endive Borrage Bugloss Fumitory Hope Maidenhair Asparagus Roots Polypody Mother of Time and Syrups made out of these and more especially that oâ— Hops Fumitory Succory the Byzantine Syrup and the Syrup of Maidenhair Now the Humors are evacuated by the Leaves of Sene Polypody black Hellebor Jalap the compound Syrup of Polypody the Electuary Dracatholicon Confection of Hamech Extract of black Hellebor the Melanagoge Excract The forms oâ— these are elsewhere propounded and so they are also in the Chapter of the Scabs And sometimes also Venesection if the Age and strength wil bear it is to be instituted and because that it often falleth out that either the Haemorrhoids or the Courses suppressed and kept it may afford matter and occasion unto this Evil it wil therefore not be amiss to provoke and draw forth these Haemorrhoids or Courses But for the tempering and allaying the heat of these Adust humors as also of the Bowels themselves there is nothing that doth it sooner then the Whey of Goats Milk which may be given from one pint to three But it wil be better for use if there be added some Juyce or Syrup of Fumitory But that which more especially correcteth the
Johannes Prevotius principal Professor of Physick in the University of Padua maketh in that Letter of Advice and Counsel which he wrote unto the Illustrious and most generous Lord Nicolaus Sapieha chief Standard-bearer unto the great Dukedom of Lituania and Earl of Coden c. I shal anon give you the whol Letter at large where he thus writeth The Nature of this poyson saith he is altogether unknown so that as it seems to me it was truly spoken by that illustrious person who said in my hearing that the Boors inhabiting within his Territories had sound out more of the original of this Plica the progress and the Cure thereof than any of those Authors that had written concerning it of which there hath been never a one of them that as yet hath had the fortune to restore unto perfect health any one that hath been afflicted with the said Plica The Physick Professors of Padua have indeed made trial there of very many Remedies but al to no purpose The same aforesaid Noble person Count of Coden himself told me that a certain Padua Physitian induced thereunto as it were by the signature shape of the Disease for they that are affected with the true and perfect Plica seem in a manner to have Serpents hanging down from their heads and as it were the head of the Monster Gorgon prescribed him some Vipers to eat but without any success at al. And that another of them had provided him a Psilothrum Oyntment to use instead of the usual Ley perswading him to condescend unto the cutting off of his hair promising him an artificial covering for his head but that being advised to the contrary by a German a student in Physick unto whom this Disease was not altogether unknown and one who wel understood the danger that was like to follow upon the rooting out al his hair he therefore refused it But although I dare not arrogate unto my self a perfect knowledg of this Disease and albeit that in no case we cannot attain unto the perfect and exact knowledg of Diseases that depend upon an occult and secret Cause yet nevertheless what I know touching the Nature of this Disease by means of my converse with the Noble Earl before mentioned who was afflicted therewith and what I conceive touching the Cause thereof I wil here briefly acquaint you with that in so doing I may give a further occasion and encouragement unto such as live in those Regions where this Disease is commonly and familiarly known to publish what is come to their knowledg touching this Disease It seems not to me to be any new Disease For although it hath hitherto been unknown unto the people of Italy and most of the European Regions yet nevertheless I see no reason at al why it should not be common and frequent in Polonia many Ages past as wel as now since that the causes that produce the same at this day might then be present as wel as now only that there were then wanting Physitians that might inquire into and acquaint us with what they knew touching the Nature of this Disease Now as for the Nature of it we are first to take notice of this to wit that this Disease as for what concerns the name thereof is known indeed from the intricateness and intangling of the hairs yet notwithstanding that the said Plica is only somwhat that is Critical as it were arising from the expulsion of the vitious matter out of the body and that the said Plica bringeth no danger at al along with it unto the affected person who oftentimes bears it about with him al his whol life without any the least damage But that which most of al threateneth danger unto the diseased party is that vitious humor which yet sticking fast in the body exciteth those most grievous symptoms that have been before recounted in the History of this Disease which cease al of them afterward so soon as the matter is thrust forth unto the hair And moreover this is further to be added unto the History That in such as are thus affected especially if the Disease proceed unto the height not only the hairs are vitiated but the nails also and more especially in the feet but most of al in the great Toes thereof which become rough long and black like unto the horn of a Goat and this I observed in the afore mentioned noble Lord Nicolaus Sapieha and I have heard that the very same hath also befallen unto others But now this Vice is not without cause referred unto and reckoned among Diseases in regard that the hairs are not wholly to be excluded out of the number of the parts And it is to be referred unto the Diseases of Conformation seeing that the hairs neither retain that figure that they ought naturally to have neither do they every of them appear single and severed as they should but are variously complicated among themselves and entwisted one within the other so that of many hairs there is made one long thick intangled and frightful lock And yet notwithstanding that the Distemper of the hairs is likewise changed cannot be denied in regard that there floweth unto them a preternatural humor and such like hairs as these when they are cut pour forth blood As touching the Causes thereof in the first place these things that are commonly believed and by tradition pass from hand to hand touching the paines that is taken by the Incubi Infants not baptized and other Spirits besides in the weaving of the long ugly and frightful Locks there is none but may easily perceive that they are meerly fabulous and superstitious But that this vice of the hair as wel as many other Diseases may somtimes proceed from Witchcraft and Inchantment appeareth even by the Observation of Christophorus Rumbaumus Doctor and Professor of Physick and my fellow Citizen which Hercules Saxonia reporteth to be Extant in the Observations of Johannes Schenckius the Elder in the seventh Book in these very words of Rumbaumus In the yeer 1590. while I was a long time bestowing my pains though all in vain in the Cure of a Mans Wife who out of the Lees of Beer artificially destilled Brandy Wine at Uâ—atislavia being newly brought to bed and by reason of a great and sudden affrightment upon occasion of a lamentable sire burning the next adjoyning houses taken with an Inflammation of the Lungs upon the retention of her Courses Secundine and what should afterward have come from her and this Inflammation through her own carelessness terminating in an Impostume of the Lungs and the Consumption a certain Emperick an old Woman came unto her and offering her pains promised present help Which she would by no means admit of Whereupon the Emperical old Woman growing much enraged uttering many threatning words she causeth her to be shut out of doors and then presently as she was wont she fals a washing and Cleansing away the filth of her Head having first Combed plaited
replied that this Disease was hereditary unto him for his Mother as he said had seven of these Plica's two Ells long all her life long even unto her dying day The same Man related this likewise for a truth that being a Souldier in Hungary and taken prisoner by the Turks his Master according to the custom of that Nation caused all his hair and withall this Plica of his to be cut off and that he thereupon became blind but that having by an Interpreter acquainted his Master with the Cause of this his blindness and obtained of him that his hair might be suffered to grow forth again he afterward recovered his sight Signs Diagnosticks There is no need at all that we add any more Signs since that there wil appear signs sufficient from the History of this Disease before reâ—iâ—ed But that we may in few words give you the Causes of those things that happen in this Disease in the first place if that said matter of this Disease whether it he malignant or whether it be simply unfit for the nourishing of all other the pâ—â—ts besides the hairs be abundantly heaped up â—n the Veins it is then by Nature unto wheâ—n iâ— is burthensom thrust forth from the more Noble unto the Exterior parts whereupon the bones are much damnified and diminished the Joynts loosned the Head Feet and Hands and all the Limbs and Joynts infested with pain Convulsions excited and the Members contracted But it Nature be so strong as to get the Mastery the at length thrusteth forth the said matter unto the hairs and more especially those of the Head with the which this Matter hath a very neer alliance as in such as are Arthritical the Cause of the Gout Arthritis hath with the Joynts whereupon Dandrif like unto Bran and Lice are abundantly generated in the Head and from the over-great store and luxuriancy of the Matter the very hairs are Complicated and intangled within themselves so that they cannot be separated by any Art or Labor and being Cut they likewise pouâ— forth Blood Prognosticks 1. This very Malady unless the matter be thrust forth unto the hair is sufficiently dangerous so that there are most grievous pains and Symptoms excited almost in all the parts whereunto the matter is thrust forth as we told you but even now 2. But if Nature doing rightly as she should and as it were by a Crisis thrust forth this matter unto the hairs then indeed this Vice of the hair that we are treating of is excited but the Party is altogether preserved free from other Maladies since that Nature is wont to thrust forth unto the hair whatsoever there remaineth of this like vitious matter in the body and many with such like Plica's live very healthfull all their life long 3. But if such Plica's be at any time rashly cut off blindness and other most grievous Mâ—â—â—dies are from thence excited Neither is this a Fables but experience it self often teacheth us the truth hereof as the Example even of that Souldier of whom we made mention before in the Causes may sufficiently instruct us And this happeneth not as many conjecture because that these Plica's being Cut the Head is thereby exposed unto the cold Air for this may easily be prevented by a hat or some other covering put upon it but because the place into which Nature was wont to thrust forth the vitious humors is taken away and a passage forth denied unto the matter and the Evacuation thereof hindered And the same happeneth here as in old inveterate Ulcers for these may not be healed without extream danger unless the body be first wel purged and cleansed and like as issues also after they have for a while been permitted to run are not without much peril to be stopt 4. If nevertheless there be no more of this vitious matter left remaining in the body then after some time those very Plicae fal off of their own accord and therefore also there remaining now no more of the said matter in the body which I confests is a thing very hard to know it may be safe enough without any danger at al to cut off these Plicae with the rest of the hair The Cure I conceive that the perfect Cure of this Disease is altogether unknown Which without doubt proceedeth from this that in those places of Polonia where this disease is Epidemical there have hitherto lived but very few Physitians that were able to compose an artificial Method out of those things they might come to know from the vulgar touching this Disease and the Cure thereof This in the first place is certain That Purgations and letting blood avail but little in this Disease yea that they are oftentimes hurtful For so the Rector of the University of Zamoscium writeth unto the Physitians of Padua If we attempt saith he to cure this Disease with the usual Purgations it maketh it but so much the worse and to rage so much the more in regard that the Purgation is not able to overcome and master the noxious humors but only to disperse them throughout the whol body when they are thus moved for those that are affected with this pestilent Disease do thereupon burn with so great a pain of al their Members that nothing more sharp can possibly be added unto the sharpness and bitterness of their torments And the same is confirmed by Hercules Saxonia who in the place alleadged out of the Epistle of a certain noble Matron a Polonian who was troubled with this Disease writeth That the said Matron upon the opening of a Vein in the Arm was immediately taken with most extream and intollerable pains in the same Arm together with oedematous Tumor and likewise that for the very same reason a Vein being opened in the Feet there were most sharp and bitter pains excited in both her Thighs as low as the Ankles The sanne Hercules Saxonia in the same place writeth That a certain famous and eminent Captain a Polonian Joachimus de Ociesno by name told him that he had seen many that were blind and some that were lame and others other wise affected who having had Purgations administred unto them in the beginning fel into these Affects And the very same happeneth also in the Scurvy the Symptoms whereof are for the most part exasperated by the use of Purgets It wil therefore be the safest course stil taking Experience for our Guide to use the utmost of our endeavor that the said vitious matter may with al possible speed be drawn forth unto the hairs whither it is now tending In which it wil be likewise our safest course again to follow the guidance of Experience by which it manifestly appeareth that those Lotions that are made of the Plant we commonly cal Beats-breech is very available and successful in this case I confess indeed it is altogether unknown unto me whether the same may be performed by inward Medicaments But yet the very mentioning of Bears-breech brings
any other parts and why in tract of time it vanisheth of its own accord but yet wil not in the least yield unto those Remedies that cal it forth and such as we cal Alexipharmaca or Counterpoysons and lastly from whence it obtaineth that notable and altogether to be admired power of Conglutinating For neither can these be referred unto the manifest qualities of any one humor the first or second although true it is that according to the generating of these depraved humors more or less the evil may possibly creep more or less and be more or less confirmed This may wholly be said which is likewise usual in the explaining of al other poysons that those Waters and the exhalations thereof are infected with a poyson endued with this property that it is more annoying unto the head is fixed more pertinaciously unto the root of the hairs bindeth them together most strongly and wonderfully writheth them and most obstinately resisteth all kind of Remedies whatsoever by reason that the peculiar nature and generation of this poyson is altogether unknown insomuch that this Noble man seemed to have said but the very truth unto me that some Boors there were within his Territories that had discovered more of the original of Plica as also of the progress and Cure thereof than those Authors that had written concerning the same none of which have as yet been so successful as to restore unto perfect health any one that hath been afflicted with this Plica But for the Scurvy it is to be esteemed a far more grievous Malady in regard that it creepeth into the whol blood and the corruption thereof prevailing and getting strength may at length cause death unto the party therewith affected which the Plica if let alone without cure and not medled withal never yet did unto any So that this Noble person is not without good cause very much perplexed and troubled as touching this his Malady being in good earnest grieved that there is hardly any regard had unto this Affect in this City where there hath scarcely ever yet been seen at any time any one infected with the Scurvy And I for my own part although I have seen two Hollanders and one English man both at Venice and at Padua also al three of them affected with an exquisite Scurvy yet I neither expect nor desire that any Credit should be given unto what I say but yet notwithstanding from what I find written touching the Scurvy by Forestus Eugalenus and Sennertus most truly and according to what they had seen and found attested by many Histories I shal presume and that very confidently to affirm that this illustrious Lord is at present much afflicted with the Scurvy For excepting only the swelling of the Lips and the flagginess of the putrid Gums the Accidents of the Scurvy confirmed al other signs and tokens of the Scurvy are present to wit the much and long use in former time of salted and smoke-dried flesh unto which the Soldiery in the Septentrional parts are extreamly addicted add unto this the loosness of the Teeth with some kind of itching in the Gums the continual great lassitude and weariness of the parts and especially of the internal the extension of the left Hypochondrium and the Mesentery and the broad Efflorescencies one while wan and other whiles red budding forth continually here and there throughout the whol body without any Feaver which is conceived to be a Pathognomick Symptom of the Scurvy Unto this we may add that this illustrious person about some three yeers since was apparently affected with the Scurvy and that the Physitian who then had him in cure being most expert in the knowledg of the Scurvy told him plainly and freely at his departure that the reliques and remainders of the Scurvy were not in the least to be sleighted by him but upon al occasions opportunely to be prevented But perhaps the Italian Physitians do therefore sleight and but little account of the name of the Scurvy in regard that they are of opinion that al the aforesaid accidents may be al of them referred unto those causes that are evident and not called by unusual names and such as in former times were not so much as ever heard of For the redundance of the adust Melancholy which is much defiled with Ichores and thin Excrements which said redundance of Melancholy and other the said humors that they are at present to be found in this illustrious Lord is manifestly shewn by the boyling heat of his Liver the weakness of the Spleen the familiar flux of the Haemorrhoids and the frequent use of meats salt and earthy may possibly breed and produce a lassitude and litherness but more especially in the internal parts unto which the humor by its weight and heaviness naturally tendeth Unto al this it may be added that it much impaireth the strength and natural powers enervates and weakens the body and extenuateth the same by corrupting the Aliment it extendeth likewise the Natural Bowels by its great plenty and thickness and obstructeth the same by the admixture of the diffused Ichorous Excrements with the overhot blood Neither are we at al to wonder that various spots arise since that both by its own proper thinness that more hot part of the adust humor is easily carried forth unto the outside of the body and that the expulsive faculty of the internal Bowels being irritated it is no hard matter for it to be purged forth through the loose skin being porous and weak And therefore to me there seemeth to be no cause why we should abuse the new and unusual name of the Scurvy in the explaining of things so wel known But how many sick persons have been most miserably cast away through this kind of reasoning we may every where read in those Authors that have written touching the Scurvy who all of them with one consent affirm that never any yet being affected with the Scurvy and having had administred unto him only these remedies that have acted by a manifest quality and such as were proper to evacuate and temper Melancholy adust and to take away the obstructions of the Bowels although administred by the most able and expert Physitians was thereby perfectly cured in regard that the Melancholy blood in this Disease contracteth a corruption peculiar and such as cannon wel be expressed which ought to be removed and taken away by those Alexipharmaca that are fit and proper for it and that otherwise irritate and enrage adust Melancholy if we regard the manifest qualities For Spoonwort or Scurvy-grass Water Pimpernel and certain kinds of the Cresses and Water Parsley al of them being most sharp and unto which alone the Scurvy giveth place seeing that they attain unto the third degree of heat and greatly dry they would vehemently increase the vices of the adust Melancholy and al the causes thereof unless by their Alexipharmick quality they opposed the corruption of the Scorbutick blood And that the
ceased and his strength by degrees returned there being no purulent spittle at all that offered to come forth his Cough likewise and difficult breathing were not very urgent and troublesom neither for the first Week did any heat and thirst very much affect the sick person in the interim the wounds being handled after the Vsual manner there daily flowed forth an indifferent Quantity of well concocted pus or purulent matter These means being continued unto the second month and the External wounds being purified and consolidated the sick person was suddenly taken with a most dangerous suffocation so that he was in great peril of being strangled by an Asthma as it were and he was likewise very much afflicted with a cough Atrophy and Hectick Feaver until at length the imposthume of the Lungs brake and with the Cough five or six pints of purulent matter were cast up at his mouth after which the exulceration of the Lungs being cured by fit and proper Remedies the consumption Fever Hectick and all the rest of the symptoms remitted and the Patient was restored unto his perfect health To wit those Wounds of the Lungs are not mortal in which only the substance of the Lungs is hurt and not the great vessels and such as are not so great that they abolish respiration or suddenly destroy the vital faculty either by their dislipating the sprits through some notable Hemorrhage or else suffocating the heart by pouring out the blood upon the Lungs and upon the heart On the contrary if the wound of the Lungs be great and that not only the substance of the Lungs but likewise the great vessels that are therein to wit those notable and observable branches of the Arterial vein and the veiny Artery be wounded those wounds are mortal being such as in which the blood and vital spirit is poured forth and dissipated or else through the overgreat abundance of the blood the Lungs and heart are oppressed and the Patient suffocated Hippocrates in the place alleadged in Coacis addeth yet another cause of death which yet nevertheless doth not bring so sudden a destruction unto any person as those in the former case even now mentioned where the wound being great it is not the vessels containing the blood that are indeed hurt but the great and rough Artery so that by reason of the largness of the wound there is more breath that goeth forth by the wound then by the mouth for then by reason of the sympathy the heart is affected the vital spirits dissipated the Lungs and heart by the ambient Air altered and offended And indeed those wounds of the Lungs bring death likewise in which either the substance of the Lungs beginneth to be exulcerated and that a Consumption is excited or in which the blood is poured forth into the Cavity of the Thorax where it beginneth to putrefy and where it causeth either a feaver or an Empyema But in regard that this doth not alwaies happen and not at al in some wounds of the Lungs and that likewise when it doth happen there is no necessity that the Patient die for this cause therefore those wounds of the Lungs are not to be accounted necessarily Mortal For Felix Platerus in his 3. B. of Obsrv Page 690. relateth that a certain person that he knew falling into a Consumption from a Wound of the Lungs was yet nevertheless Cured and perfectly recovered A certain Coffermaker sayth he one of our Citizens having from a servant of his received a wound very deep in the lowest part of the Thorax by a prick from the point of a knife by the wound he voided forth a most stinking and loathsom pus or matter by the ill savor whereof the whol neighborhood was infected and offended and likewise some certain smal parcells of his Lungs in which the cartilaginous branches of the rough Artery did manifestly appear which persevering a long time albeit that he was in a manner wholly wasted away yet nevertheless at the length the flowing forth of the purulent matter remitting the wound was closed and he restored unto perfect soundness living after this many years as a foot-post in carrying of letters and thus he prolonged his life for forty years safe and found as we say although as it is very probable he wanted great part of his Lungs in one side The wounds of the rough Artery Fifthly That the wounds of the great rough Artery commonly called Aspera Arteria are not mortal but that they may be cured even the Laryngotomy or Cutting of the Laryinx of which we have spoken before in the Second Book of our Pract Part. 1. Chap. 24. doth evidently demonstrate To wit those of them are cured that are not great and in which the membranes only by which the rings of the rough Artery are fastened and linked together are wounded examples of which Schenkius in the Second Book Of his Observat hath collected And I my self also have twice seen such like wounds cured But if those very cartilaginous rings be wounded by reason of their hardness the part cannot again be made to grow together as formerly as Hippocrates teacheth us in the sixth of his Aphorisms Aph. 19. And in the seventh of his Aphorisms Aph. 28. and Galen in Book 5. of his method of Physick Chapt. 7. And yet notwithstanding such like Wounds do not cause a sudden death but a flow and lingering one while that the Lungs are either altered and weakned by that Air that violently breaketh in upon the Lungs thorow the wound or else that a certain smal gobbet of flesh grow unto the wound which by intercepting the breath at the length choaketh the Person But those wounds alone of the rough Artery throttle the Party in which the jugular veins and Arteries being hurt the blood violently and al at once rusheth into the Lungs intercepteth the breathing and so suffocateth the wounded person which yet nevertheless happeneth not by reason of the wound of the said rough Artery but by reason of the wound of the Jugular vein or the soporal i. e. more plainly the sleep-conveying Artery that is very neer unto it Wounds of the Diaphragm Sixthly Hippocrates reckoneth up the Wounds of the Diaphragm among those wounds that are mortal But Galen in his Book 5. of the Method of Physick Chapt. 9. distinguisheth between those wounds of the diaphragm that are inflicted upon the nervous part therof those that are made in its fleshy part and those he wil have to be mortal but these latter Curable And yet nevertheless in the Sixth of the Aphorism Aph. 18. he writeth that the wounds of the nervous part of the Diaphragm are not alwaies mortal but that the great wounds therein are only so For then it is indeed that those grievous symptoms plainly appear viz. a deliry or stupid dotage difficult breathing Feavers Convulsions and as Aristotle hath likewise observed in his third Book of the parts of living Creatures and tenth Chapt. the
Method had been practised For he himself oftentimes very rightly inculcates and writeth very cleerly that it is Nature that cureth the Wound and not the Physitian or Medicaments For if the Pus ought to be moved this is performed by Nature or if that flesh be to be generated and the broken bones to be strengthened by a Callus these are the work and business of Nature If the Wound be to be Agglutinated it is she that must do it and if the Excrements ought to be expelled this is likewise her Office And through the strength of Nature there happen Miracles oftentimes in Wounds Yea as he proveth in his 37. Chap. a strong Nature wil likewise bear out and overcome the Errors of the Chirurgeon committed in the Cure And so no doubt may those Chirurgeons that stil use the old way and Method of curing produce the like examples on their part That Student that was run through the Thorax his Lungs being withal wounded of whom we made mention in the 2. B. of our Practise 2 Part. Chap. 11. and a little above in the 3. Chap. of the Wounds of the Lungs was cured within the space of one Month the care of which Wound in regard that it was inward was chiefly to be committed to Nature and the cure thereof to be ascribed unto her and not either unto the old or the new way of Curing And Glandorpius relateth that a Wound of the Oesophagus was in twenty four daies drawn all over with a Cicatrice as you may find the relation in his Speculum Chirurgic Observat 30. And indeed I will in the next place most readily grant him that those frequent terebrations which seem somtimes to be instituted rather for the exercising of the Chirurgeons Body then for any need the Patient hath of them are not alwaies safe and that they somtimes bring more damage then benefit unto the sick person But yet that the Wounds of the Head are not to be uncovered before the fifth or the seventh day this I shall not so easily grant him seeing that such Wounds pass through divers parts and heap up divers sorts of Excrements and for the most part there is Blood collected between the Skul and the Membranes of the Brain which is therefore with al possible speed to be evacuated For which cause the Terebration also and the perforation of the Skul is somtimes necessary lest that this Blood if it be kept in putrifie and so cause grievous Symptoms Yea and as oftentimes it doth bring Death it self upon the wounded person which may likewise very easily happen if those Wounds should seldom be opened and cleansed Secondly The Reasons alleadged by Caesar Magatus and out of him by Ludovicus Septalius are of no great moment at least they carry not that weight in them that may perswade the rejecting of the old and usual way of curing Wounds First they mainly urge this and indeed herein chiefly consisteth the very strength and pith of this Opinion that the heat of the wounded part is to be preserved and they accuse Galen for that he hath omitted an indication of the greatest moment and that he hath troubled himself more then he needed in other things of far less moment and about the generating of Excrements in the Wound whereas if the innate heat be preserved there will be but very few Excrements bred and those that are will be such as can no waies hinder the glutination of the Wound Where we willingly grant and do confess that Nature as she is the Curer of other Diseases so she is the healer of Wounds likewise and that it is she alone and not the Medicaments that by the benefit of the Natural heat doth perform this glutination of Wounds and therefore that the innate heat and the natural temperament of the part is carefully to be preserved and cherished And this albeit that Galen hath passed it by in that place where he professedly treateth of the Cure of Wounds but whether he hath therein done well or ill I here dispute not yet notwithstanding in other places he often inculcates that there cannot possibly be any curing of the Wound unless the part obtain its own Natural temper and those very Medicaments which are called Sarcotick are provided for that very purpose the Conservation of the heat of the part as we said before in the precedent Chap. But here two Questions arise the first this whether the natural heat be preserved bettter in this new way or in that other old and wonted Method of curing and whether or no there be any necessity that more excrements should be generated in the old way then in this new manner of curing The Second Question is this whether the alone preservation of the Native heat be sufficient for the curing of the Wounds We deny both As for the First it shall be shewn in the following Arguments that the more rare and seldom opening and uncovering of Wounds is oftentimes more hurtful and prejudicial unto the Native heat then useful and serviceable thereto but on the contrary the more frequent uncovering of the Wound and as oft as there is need thereof is no way offensive unto the Native heat and that therfore it is not by reason of the uncovering of the Wound but by reason of the debility of the heat or the constitution of the part or the Body that those Excrements are generated For when there is blood poured forth in the Wound from hence it is that the heat and spirit is dissipated and the part rendered the weaker from whence it is likewise that in the Concoction that is made in the part there are very many Excrements generated And that somtimes fewer and somtimes more Excrements are generated in the Wound this is not therefore because that the Wound is more seldom or more frequently opened and uncovered but because the whol Body and the wounded part are more or less disposed unto the generation of the said Excrements But as for the Second to wit that the innate heat alone is not alwaies sufficient for the curing of the wound this is apparent since that there oftentimes so many impediments and obstacles cast in Natures way that unless they be by the Physitian removed and that indeed very frequently even every day Nature can by no means attain unto her end and drift The Pus first of all and the Excrements that are collected in the wound are to be evacuated and somtimes a passage forth likewise made for them as oft as need requireth by Tents and those Medicaments that cherish the heat dry up the Excrements and hinder the generating of them and help forward the Glutination of the wound are often to be laid on since that when they are once laid on they are soon defiled with the Pus and Sanies that is to say the thick and thinner Excrements of the wounds and thereby weakned and the virtue of them is likewise otherwise dissipated by the heat of the part And albeit
the Nerves although that there shall be no pain felt neither any Inflammation appearing yet notwithstanding we are not to trust to this but for all this the Cure is carefully to be heeded and attended The Cure Touching the Curing of the Wounded Nerves Galen in his sixth Book of his Method of healing Chap. 2. taketh a great deal of pains in treating thereof But seeing that in all Wounds of the Nerves pains and inflammations easily make their approach and threaten the patient we must endeavor that the pain may be mitigated and the inflammation prevented And therefore if need require both by letting forth of the blood as also by a purging out of the sharp and thin humors their afflux unto the affected part is to be restrained and prevented but the wound it self is to be kept open that so the excrements may the more freely flow forth For the Chiefest cause of pain in Wounds of the nerves is the excrementitious matter shut up which being over long detayned getteth to it self a depraved quality pulleth and twingeth the Nerves and at length putrifieth And therefore those Medicaments that are called Enemata although they may be very fit and proper in bloody Wounds and those of the fleshy parts in regard that they speedily close shut up the wound yet here in this case are no waies convenient Neither is water fit proper nor yet any thing that is cold since that as Hippocrates writeth in his fifth section Aphoris 18. every thing that is cold is an enemy to the bones teeth Nerves Brain spinal marrow but that which is warm a friend unto them Yea neither ought other Medicaments that are actually cold to be administred unto the wounded parts For seeing that the Nerves are parts voyd of blood and having in them but very little natural and inhate heat and endued with a most exquisite sense they are soon and easily offended by any thing that is cold it being biting and causing pain as Hippocrates writeth in the 20. Aphor. of his fifth Section and as Galen likewise teacheth thus in the sixth Book of his Method of Curing Chapt. 3. But yet things that are blood-warm are not sufficiently commodious touching which Galen in his sixth Book of the Composit of Medicaments according to the kind Chapt. 2. thus writeth Let the oyl sayth he with which we cherish the wound be sufficiently hot lest that otherwise it offend such a wounded part For like as that which is cold is most of all contrary unto these kind of Affects so likewise that that is but blood warm is not very much a friend unto them And a little after and for this Reason sayth be I my self chuse rather to make use of a fomentation of oyl that is sufficiently hot alwaies shunning that which is but luke-warm but most of al refusing that which is quite cold And yet Nevertheless if there be a nerve discovered and made bare Galen then administreth rather such things as are but tepid or Luke-warm then those things that are very hot as we may find in the sixth Book of his Method of Curing and Chapt. 3. But although that for the asswaging of the pain that which is hot and withal moyst is most useful and convenient yet nevertheless in regard that under those things that humectate and moysten the Nerves do easily putrefy therefore for all Wounds of the Nerves those Medicaments are most accomodate and proper that in their activity are temperate or somwhat tending unto heat but that in passives do dry and that are of thin parts that may corroborate the weak heat of the Nerves by consuming and drying up the excrements touching which Galen in his sixth Book of the Method of Curing and 2 Chapt. writeth in this manner The faculty of the Medicaments of the wounded Nerves ought to be both thin and also moderatly heating and such as may dry without any pain in regard that this alone can draw the Sanier or thin excrements from the bottom of the Wound without either contracting or biting of the particle And then a little after the Wounded Nerves sayth he require such Medicaments that may excite a tepid or luke-warm heat and may strongly dry and which from the Nature of their own substance have both a power of drawing and are of thin parts And the same he teacheth us in his third Book of the Composition of Medicaments according to the kinds Chapt. 2. And such like Medicaments have in them this benefit likewise that although they are endued with a faculty of drying yet notwithstanding they do not conglutinate the orifice of the Wound seeing that they have both an attractive power and yet nevertheless are free from and void of an Astringent faculty And yet notwithstanding regard ought to be had unto the nature of the Wounded person and unto the softer and more tender bodies the weaker Medicaments are to be administred but unto hard and strong bodies those medicaments that we administer may be the stronger And there is also regard to be had unto the matter that is to be dryed up and according to the store of the humidity we are to make choice of Medicaments that are conveniently drying For as Galen in the place last alleadge to wit the third Book of the Composition of Medicam according to the places and Chapt. 2. sayth that in a very copious humidity the increase thereof requireth to be dryed up by a Medicament that is more then ordinary drying if it be buy little then by a medicament that doth this moderately and if it be much hen by a Medicament that dryeth much and yet nevertheless not extremly neither in the highest degree For there ought to be a proportion answerable between the quantity of the humidity and the drying of the Medicament And if there be also any of those drying Medicaments and of thin parts which are of fit use in all Wounds of the Nerves that have adjoyned with them a Notable heat and a biting Acrimony and thereupon may easily excite both pain and fluxions such as are destilled Balsams spirits and oyls their heat and acrimony unless of its own accord it soon vanisheth as it commonly happeneth in the spirit of Wine is to be tempred and Mitigated by the mingling together of other things with them Such like Medicaments as these that are useful in all Wounds of the Nerves are propounded by Galen in his sixth Book of the Method of Curing Chapt. 2. and in his third Book of the Composite of Medicam according to the kinds Chapt. 3. 4. and 7. and they shal be likewise declared by us anon when we come to speak of the pricking of the Nerves But now that the pain may be asswaged the temperament of the part preserved and the Afflux of humors and the inflammation may be prevented there are not only convenient Medicaments to be imposed upon the part affected of which we shal speak by and by but even al the parts also that lie in
its proper place and that there be no Contusion of the parts incumbent and lying neer then some gentle Medicament that is fit and Convenient for a fracture and inflammations is to be layd on of Frankincense sine flour Bole Armenick the White of an Egge and the like But if the broken Ribb stick forth outwardly it is to be pressed together with the hand and to be reduced unto its Natural situation and here also a Convenient Medicament is to be imposed But if the broken Ribb tend inwardly we must endeavor that it may be brought back into its own place And therefore we must first of all see whether by the Cough and the holding of the breath or by the help of the hands the broken Ribb may be restored again into its own place which if it succeed not then we must lay on some Emplaster that will attract and that will stick fast unto the Ribb and then this Emplaster is again with violence to be taken away that so the Ribb may be brought back again into its own place And very Convenient for this use is this Emplaster also Take The finest wheat flour two ounces Tragacanth Frankincense powdered of each five drams Missleto of the Oake to wit the Glew six drams Ichthyocolla or Fish Glue one ounce and half Whites of Eggs two ounces Rose-water as much as will suffice and mingle them Or an Emplaster made of Turpentine Rosin blackpitch Barly Meal or Beanmeal Mastick and Aloes And such like emplasters as these are often to be applyed and then to be taken off when the sick person shall breathe more freely And I my self remember likewise that some yeers since a certain Cooper having a Ribb broken and depressed in his right side by the violent recoyling of a hoop which he was bending to make a hoop for a Hogshead or tub so that he could very hardly draw his breath Coughed extremly and was not able to lift himself up straight I applyed and layd on such an Emplaster as this that we have mentioned and thereby brought back the Ribb again into its proper place Some there are indeed who endeavor the bringing back of the broken Ribbs into their places again by the applying of Cupping-glasses but Most Physitians dislike this practise there being great cause to fear lest that by this means there be more of the humor attracted and that otherwise the flesh above the Ribbs is wont to be puffed up But if any broken fragment of the Ribb prick the Membrane so that thereupon most grievous pains and other ill symptoms arise in so much that there be great cause to fear death that part wherein the Ribb is broken is to be opened with the incision knife that so we may the better come at the fragments that prick either to pluck them forth or to cut them off And if likewise there be present any contusion or bruise a vein is then to be opened lest that an Inflammation follow The Ribbs being reduced unto their own places again Nature will then indeed of her own accord generate the Callus which that we may the better assist some Emplaster that is convenient for a fracture of the bones is to be imposed among the which this that followeth is one of the chiefest Take Pouder of Myrtles and red Roses of each one ounce the Meal of Barly of the bitter vetch orobus and of Lentiles of Beans and of Mastick of each two drams Acron Cups Cypress Nuts the rinds of them Frankincense Dragons blood Earth of Lemnios Aloes and Myrrh of each two drams Oyl of Myrtle of Roses and oyl omphacine of each nine ounces Wax and cleer Turpentine of each half a pound and make an Emplaster Some there are that in the progress of the disease wet and soak the swathes in Rosemary water which as they write is a very special and effectual water in all fractures of the bones But if the flesh be moyst and flaggy then the Medicaments before propounded are to be imposed and the place is to be streyned together with swathes and other Coverings that so the flesh may again be conjoyned with the bone And if through Negligence of the Physitian or the sick person himself the Malady be now become old and inveterate and that the flesh be rendered soft and snotty so that there be cause to fear lest that the bones Gristles and Membranes may be hurt we are then to do our endeavour that the said snotty Juice may be discussed by such digesting Cataplasms as we shall anon speak of But if this may not be done the burning iron is the best Remedy and yet here we are to be very cautious that the bone be not made hot or the inward parts hurt If that which was bruised tend toward a Suppuration the Matter is then to be resolved and evacuated with a Cataplasm of Barly meale Bean meal or of the bitter vetch Orobus Camomile flowers and the like As Take Meal of Beans and Barly of each two ounces Wormwood half an ounce the pouder of Camomile flowers Melilote and Eldern of each one ounce boyl them in Spring Water and then add Oyl of Camomile and Roses of each one ounce and make a Cataplasm But if the matter cannot yet be discussed by these Medicaments all delay is to be avoided for fear lest that the bone be vitiated and therefore in that part wherein it most swelleth the part is to be opened either with the Penknife or with the hot Iron that so a free passage forth may be opened for the Pus The Dyet Let the Patients Dyet at the first be thin and very sparing and such as is required in other acute Diseases Let the sick person keep himself as quiet as he can without any Coughing or Sneezing as much as may be let him not talk much nor laugh nor Chafe See Hippocrates in his 3. B. of the Joynts Text 54. c. Galen in his Comment upon the place and Ambrose Parry in his 14. B. and 12. Chapter Chap. 18. Of the Fracture of the Spina Dorsi or Back-bone ANd somtimes it likewise so happeneth that from external and violent Causes the Spina Dorsi or Back-bone and its Vertebrae are broken Signs Diagnostick If the Spina or Back-bone be hroken then there appeareth a Cavity in that place and there is a pain and pricking felt in regard that of necessity those broken fragments of the bones must needs be very Thorny and Pricking as Celsus tels us in his 8. B. and 9. Chap. And if any process of those broken bones that stick forth be broken this is discerned by the touch because that it may be moved this way and that way And moreover if the sick person lie upon his Face the pain is so much the greater and far more then if he stand upright For there the Skin is extended and bruised with the sharp broken fragments but if the sick person stand upright the Skin is then loosened and not so much pricked by
of theirs since that those who are affected with the Elephantiasis are not made hereby ever a whit the greater unless haply we have respect not so much unto the greatness of the body in such as are thus affected as unto the greatness of the danger of death thereby threatned to wit that look as the Elephant is the greatest of al the four-footed Creatures even so among diseases this appeareth to be the greaâ—est and an Affect almost remediless and incurable touching which thing Macer in his Book of the virtues of Herbs and Chap. 15. speaketh unto the same purpose Or else this Malady is so called because that creeping along upon the Thighs it causeth them to become as are those of an Elephant rough and unequal or else because that among other Diseases this is exceeding vehement strong and violent like as is the Elephant or otherwise it is so called and this indeed seemeth to be the most true and genuine reason thereof because the members the skin of those that are affected with this Disease are rendered tumid and swoln scaly rough and rugged ful of swellings and unequal like unto the skin of Elephants Galen in his Book of Tumors Chap. 14. writeth that this Malady when it first beginneth is likewise called Satyriasmus in regard that the face of those that are afflicted with this Disease is rendered like unto the face of the said Satyres For the lips of such as are troubled with Elephantiasis are thereby made thick and the Nose swelleth and thereupon it seemeth as if it were pressed down the Ears become flaggy and much wasted the Jaw bones are colored as it were and overspread with a certain kind of redness and in the Forehead there appear here and there Tumors or Swellings like as if they were certain Horns although there be others indeed that think the Satyriasmus to be so called even for this very cause that in the beginning of this Malady the sick parties are extreamly libidinous and lustful like as are the said Satyres And yet notwithstanding Aetius in Tetrab 4. Serm. 1. Chap. 120. out of Archigenes rendereth another kind of reason of this resemblance and that indeed different from the former to wit because the Cheeks and face in such as are thus affected are lifted up together with a certain redness and the Chin it self is dilated upon the Convulsion as it were of the Muscles of the Jaws even as we see it likewise to befal those that laugh in a certain kind of likeness and resemblance unto the Pictures of Satyres which Coelius Rhodiginus in his 19. Book of the reading of Antiquâ—ties and Chap. 25. conceiveth to be â—o called from the Greek word Seserenai because that these Satyres sing and sport themselves with their mouths wide open and gaping and their lipâ— drawn forth like unto those that laugh A d there are some that give us a thâ—â—â— reâ—son and ground of this appellation to wit b cause thâ—â— those who are affected wiâ—h thiâ— Elephantiasis are like unto Satyres in their propension unto Venery and lustfulness It is likewise termed Leontiasis either in regard that this Malady is inviâ—â—ible like as the Lyon or else because as Aetius hath it in Tetrab 4. Serm. 1. Chap. 30. the forehead of the sick person is with a certain swelling rendered and made more loose after the resemblance of the flexile skin of the Lions Eye-brows or else because the breath and the very spiriâ—s of such as are affected with this Malady do even stink like unto the breathing of Lions and their very excrements also or else because those that are affected with this Disease have a most filthy and terrible face insomuch that like as do Lions they strike a terror into those that come suddenly and unawares to behold it This Malady is by our Physitians called the Malady of St. Lazarus because that such as are Elephantiack do so abound and are ful of Ulcers like as was that Lazarus the beggar of whom there is mention made in the Evangelical History Luke Chap. 16. Now this is a very sad and grieâ—ous Malady and as it were an Universal oâ— Cancer of the whol body whereupon it comprehendeth under it many more sorts and kinds oâ— Diseases For fi st of al there is present magnitude augmented and a â—â—â—lling up and down in the body especially in the external parts whose beauty feaâ—ure and 〈◊〉 likewise is hereupon corrupted there is likewise present a hot and dry distemper by which the parts are so exulcerated and corrupted that as length they fal off Celsus in his third Book and Chap. 25. thus describeth the whol Idea of this Malady The whol Body saith he is affected so that the very Bones likewise may in a manner be said to be vitiated and corrupted The highest and utmost parts of the body have in them both spots and swellings that stand thick and close one by the other The redness of these parts is by little and little converted into a black color The top of the skin is unequally both thick and thin hard and soft and is exasperated by certain scales the body waxeth lean the mouth the calves of the legs and the feet swel and are puffed up When the disease comes once to be old the fingers and toes are quite hidden under the swelling there ariseth also a light and gentle Feaver that easily consumeth and wasteth the sick person that is already overwhelmed with the aforesaid evils and mischiefs The Causes The containing cause is black Choler and this not without malignity diffused and spread abroad throughout the whol body Now we find touching the generating of this humor viz. black choler a long and tedious dispute among Authors and we find them holding divers and different Opinions In this the truth is they al agree that this humor is generated from the adustion and burning of other humors but then in this they differ viz. from the adustion of what humors this proceedeth Avicen in the third Section of his fourth Book Tract 3. Chap. 1. seemeth to have comprehended them all whiles he mentioneth five Species or kinds of this humor The first is that which proceedeth from the Blood the second that from the melancholly humor the third that which is from the adustion of bitter Choler the fourth that which ariseth from Flegm burnt the fift and last that that proceedeth from the thick and hot part as being very apt to be burnt of the Chyle as to Instance from all salt Flesh Fish and the like But although it cannot be denied that there is here in this case an adustion of humors present and that salt humors are the cause of this Malady yet notwithstanding since that there are very many other Tumors and Ulcers that have their original from adust humors here therefore the very specifical cause is altogether to be sought for which notwithstanding cannot easily be explained but it consisteth in an occult i. e. an hidden and secret Malignity But